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内淋巴乳突分流术治疗难治性梅尼埃病患者的长期疗效

Long-term results of endolymphatic mastoid shunt surgery in patients with intractable Ménière's disease.

作者信息

Yu Myeong Sang, Lee Kwang-Sun, Chung Jong Woo

机构信息

Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.

出版信息

Otolaryngol Head Neck Surg. 2009 Aug;141(2):237-42. doi: 10.1016/j.otohns.2009.03.014. Epub 2009 Jun 26.

Abstract

OBJECTIVE

To evaluate changes in vertigo and hearing from patients with Ménière's disease managed by endolymphatic mastoid shunt (EMS).

STUDY DESIGN

Case series with chart review.

SETTING

Tertiary referral center.

SUBJECTS AND METHODS

Data from 16 patients were analyzed using 1995 AAO-HNS criteria.

RESULTS

Among 16 patients, six had class A vertigo control two years after treatment, five had class B, one class C, three class D, and one class F. At four years after surgery, seven patients had class A, four class B, three class C, and two class F. The mean functional level before surgery was 4.8 and improved to 2.9 and 2.6 at two years and four years after surgery, respectively. The bone conduction pure-tone averages (four frequencies) were 43.3 before surgery and improved to 33.5 dB HL and 35.5 dB HL at three and six months after surgery, respectively. At two years of follow-up, the hearing level was 38.6 dB HL and was not different from the preoperative hearing level. Two years after surgery, the hearing level gradually decreased and was 42.0 dB HL at five years of follow-up.

CONCLUSION

EMS appears to be beneficial in the short term for the symptomatic patients.

摘要

目的

评估采用内淋巴乳突分流术(EMS)治疗的梅尼埃病患者的眩晕和听力变化。

研究设计

病例系列研究并进行病历回顾。

研究地点

三级转诊中心。

研究对象与方法

采用1995年美国耳鼻咽喉头颈外科学会(AAO-HNS)标准分析16例患者的数据。

结果

16例患者中,治疗两年后6例眩晕控制为A级,5例为B级,1例为C级,3例为D级,1例为F级。术后四年,7例患者为A级,4例为B级,3例为C级,2例为F级。术前平均功能水平为4.8,术后两年和四年分别改善至2.9和2.6。术前骨导纯音平均听阈(四个频率)为43.3dB HL,术后三个月和六个月分别改善至33.5dB HL和35.5dB HL。随访两年时,听力水平为38.6dB HL,与术前听力水平无差异。术后两年,听力水平逐渐下降,随访五年时为42.0dB HL。

结论

EMS对有症状的患者在短期内似乎有益。

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