前庭神经切除术与化学性迷路切除术治疗致残性梅尼埃病的长期对比研究

Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study.

作者信息

Schmerber Sébastien, Dumas Georges, Morel Nils, Chahine Karim, Karkas Alexandre

机构信息

Department of Otorhinolaryngology, Grenoble University Medical Center, BP 217 - 38043 Grenoble Cedex 9, France.

出版信息

Auris Nasus Larynx. 2009 Aug;36(4):400-5. doi: 10.1016/j.anl.2008.08.001. Epub 2008 Nov 20.

DOI:10.1016/j.anl.2008.08.001

PMID:19026499

Abstract

OBJECTIVE

To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Menière's disease's disabling vertigo, and to assess their subsequent effects on hearing.

METHODS

This is a retrospective study of 58 VN procedures and 35 CL procedures. Treatment results were assessed by caloric testing and pure-tone audiometry performed before and after treatment. Subjective success was defined by the number of recurrent attacks of vertigo and by the AAO-HNS vertigo scale.

RESULTS

Caloric testing revealed strong vestibular hyporeflexia in 91.0% of VN cases and 86.0% of CL cases. Vertigo recurred in 7.0% of cases in the VN group and in 11.4% of cases in the CL group. Mean pure-tone auditory thresholds increased from 45.00dB HL to 50.84dB HL (p=0.19) in the VN group and from 69.11dB HL to 74.51dB HL (p=0.41) in the CL group.

CONCLUSION

Vestibular neurectomy and chemical labyrinthectomy offer similar control of vertigo in patients with Menière's disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Menière's disabling vertigo without causing significant hearing deterioration.

摘要

目的

比较前庭神经切断术（VN）和化学性迷路切除术（CL）治疗梅尼埃病致残性眩晕的疗效，并评估它们对听力的后续影响。

方法

这是一项对58例VN手术和35例CL手术的回顾性研究。通过治疗前后进行的冷热试验和纯音听力测定来评估治疗结果。主观成功率由眩晕复发次数和美国耳鼻咽喉头颈外科学会（AAO-HNS）眩晕量表定义。

结果

冷热试验显示，91.0%的VN病例和86.0%的CL病例存在强烈的前庭反射减退。VN组7.0%的病例眩晕复发，CL组11.4%的病例眩晕复发。VN组平均纯音听阈从45.00dB HL升高至50.84dB HL（p = 0.19），CL组从69.11dB HL升高至74.51dB HL（p = 0.41）。