Yamazaki T, Hayashi M, Komatsuzaki A
Department of Neurotology, Sapporo City General Hospital, Japan.
Acta Otolaryngol Suppl. 1991;481:613-6. doi: 10.3109/00016489109131485.
In 1974 (6), 6 patients with incapacitating unilateral Meniere's disease were given an empiric treatment with intratympanic gentamicin sulfate via the eustachian tube using a catheter with a small side-branch. These patients showed excellent results, gaining relief from vertigo over a 13-year period. Since 1980 (7. 8), we have treated patients suffering from Menière's disease with isosorbide. When the patients could not be controlled by this therapy, isosorbide was given in addition to intratympanic gentamicin therapy using a tubal catheter. Of 75 patients with Menière's disease who received gentamicin and isosorbide therapy, 41 could be evaluated by the classification of the American Academy of Opthalmology and Otolaryngology (AAOO) in 1987 (9). Three of these patients suffered from repeated attacks of vertigo for 2 years. However, all of them could be easily controlled by additional intratympanic gentamicin or isosorbide therapy on an out-patient basis. Thereafter, of a further 40 patients with incapacitating Menière's disease who received gentamicin and isosorbide therapy, 15 could be evaluated by the AAOO classification. In summary, of the 115 patients with incapacitating Menière's disease treated with intratympanic gentamicin after isosorbide treatment, 56 could be evaluated by the AAOO criteria from 1987 to 1990. These patients ranged in age from 21 to 79 years. Vertigo improved in 80% of the patients: 19 patients (34%) were group A. 22 patients (39%) were group B, 4 patients 7%) were group C and 11 patients (20%) were group D, of whom 9 patients required subsequent endolymphatic-mastoid shunt operations. This treatment also effectively controlled patients with bilateral Menière's disease.
1974年（6），6例单侧梅尼埃病导致失能的患者通过带有小侧支的导管经咽鼓管接受了鼓室内硫酸庆大霉素的经验性治疗。这些患者取得了极佳的效果，在13年期间眩晕症状得到缓解。自1980年起（7、8），我们用异山梨醇治疗梅尼埃病患者。当患者无法通过这种疗法得到控制时，除了使用咽鼓管导管进行鼓室内庆大霉素治疗外，还会给予异山梨醇。在75例接受庆大霉素和异山梨醇治疗的梅尼埃病患者中，1987年（9）有41例可根据美国眼耳鼻喉科协会（AAOO）的分类进行评估。其中3例患者眩晕反复发作达2年。然而，通过在门诊额外进行鼓室内庆大霉素或异山梨醇治疗，所有患者的症状都能轻松得到控制。此后，在另外40例接受庆大霉素和异山梨醇治疗的失能性梅尼埃病患者中，有15例可根据AAOO分类进行评估。总之，在异山梨醇治疗后接受鼓室内庆大霉素治疗的115例失能性梅尼埃病患者中，1987年至1990年有56例可根据AAOO标准进行评估。这些患者年龄在21岁至79岁之间。80%的患者眩晕症状有所改善：19例患者（34%）为A组，22例患者（39%）为B组，4例患者（7%）为C组，11例患者（20%）为D组，其中9例患者随后需要进行内淋巴 - 乳突分流手术。这种治疗方法对双侧梅尼埃病患者也有有效的控制作用。
