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外侧半规管阻塞治疗梅尼埃病的前瞻性临床研究:28 例患者分析。

Lateral semicircular canal plugging in severe Ménière's disease: a clinical prospective study about 28 patients.

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Strasbourg, Strasbourg Cedex, France.

出版信息

Otol Neurotol. 2010 Feb;31(2):237-40. doi: 10.1097/MAO.0b013e3181ca85a2.

Abstract

OBJECTIVE

To evaluate the safety and efficiency of the plugging of the lateral semicircular canal to control vertigo in severe Ménière's disease (MD).

STUDY DESIGN

Prospective follow-up study.

SETTING

University hospital.

PATIENTS

Twenty-eight patients with MD with refractory vertigo and severe disability (functional scale 5 or 6).

INTERVENTIONS

Lateral canal plugging was performed in pathological ear for each patient.

MAIN OUTCOME MEASURES

The evaluation of therapy followed the guidelines for diagnosis and evaluation of therapy in MD (1995). Hearing, frequency of vertigo, and functional disability were assessed in the early follow-up (6 mo) for all the patients and in the late follow-up (2 yr) for 16 patients. In addition, the canal paresis was evaluated by caloric test.

RESULTS

No vital complication occurred. The hearing was preserved in 82% of cases. Lateral canal plugging induced in all cases a canal paresis that was persistent after 2 years. After 2 years (n = 16), the control of vertigo was complete or substantial in 75% of cases (A1, restoration of a normal life: 62.5%; B2, no functional restriction: 12.5%).

CONCLUSION

Lateral canal plugging is a safe procedure that induces a canal paresis and allows a good control of vertigo. In view of these results, the lateral canal plugging should be a therapeutic option for controlling rotatory vertigo in severe MD.

摘要

目的

评估阻塞水平半规管控制重度梅尼埃病(MD)眩晕的安全性和有效性。

研究设计

前瞻性随访研究。

设置

大学医院。

患者

28 例 MD 患者,伴难治性眩晕和严重残疾(功能量表 5 或 6)。

干预

对每位患者的病变耳进行水平半规管阻塞。

主要观察指标

根据 MD 的诊断和治疗指南(1995 年)评估治疗效果。所有患者在早期随访(6 个月)和 16 例患者在晚期随访(2 年)时评估听力、眩晕频率和功能障碍。此外,通过冷热试验评估管麻痹情况。

结果

无生命并发症发生。82%的病例听力得以保留。水平半规管阻塞导致所有病例在 2 年后出现持续的管麻痹。2 年后(n=16),75%的病例眩晕得到完全或显著控制(A1,恢复正常生活:62.5%;B2,无功能受限:12.5%)。

结论

水平半规管阻塞是一种安全的操作,可引起管麻痹,并能很好地控制眩晕。鉴于这些结果,水平半规管阻塞应该是治疗重度 MD 旋转性眩晕的一种治疗选择。

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