Chen Ying, Yang Jun, Wu Hao, Huang Qi, Wang Zhaoyan, Zhang Zhihua
Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital Affiliated Shanghai Jiaotong University School of Medicine, Ear Institute of Shanghai Jiaotong University School of Medicine, Shanghai ,200092, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Aug;25(16):721-5.
To investigate individual management for Meniere's disease and analyze outcomes of nonsurgical and surgical management of Meniere's disease.
Patients with Meniere's disease were staged according to hearing and quality of life. The individual management according to the staging was established, including outpatient treatment (lifestyle change, medical management and intratympanic steroids), endolymphatic sac decompression or drainage, vestibular neurectomy and labyrinthectomy. The characteristics of patients who underwent surgical management were analyzed. The functional outcomes of surgery in dizziness, hearing loss and quality of life were evaluated for 12-month postoperative follow-up.
Twenty patients underwent intratympanic injection of dexamethasone. Dizziness improved in 70% (14/20), tinnitus improved in 41% (7/17), and aural fullness improved in 36% (4/11). There were 55 patients who underwent surgical managements for 57 times. Endolymphatic sac decompression or drainage was carried out in 27 patients for 28 times, vestibular neurectomy in 26 patients and labyrinthectomy in 3 patients. Vertigo control rate was 75% in patients with endolymphatic sac decompression or drainage, 100% in vestibular neurectomy and 100% in labyrinthectomy at 12-month postoperative follow-up.
The non-surgical management and endolymphatic sac decompression or drainage can improve vertigo and ameliorate quality of life. Vestibular neurectomy and labyrinthectomy are effective surgical managements to eliminate vertigo. The management of Meniere's disease depends on several factors: stages of vertigo and hearing, quality of life, surgical contraindications and subjective desire. Therefore, the management for Menieres disease must be individualized for each patient.
探讨梅尼埃病的个体化治疗，并分析梅尼埃病非手术及手术治疗的效果。
根据听力和生活质量对梅尼埃病患者进行分期。根据分期制定个体化治疗方案，包括门诊治疗（生活方式改变、药物治疗及鼓室内注射类固醇）、内淋巴囊减压或引流、前庭神经切断术及迷路切除术。分析接受手术治疗患者的特征。对术后12个月随访时手术在眩晕、听力损失及生活质量方面的功能效果进行评估。
20例患者接受了鼓室内注射地塞米松治疗。70%（14/20）的患者眩晕症状改善，41%（7/17）的患者耳鸣症状改善，36%（4/11）的患者耳胀满感改善。55例患者接受了57次手术治疗。27例患者接受了28次内淋巴囊减压或引流，26例患者接受了前庭神经切断术，3例患者接受了迷路切除术。术后12个月随访时，内淋巴囊减压或引流患者的眩晕控制率为75%，前庭神经切断术患者为100%，迷路切除术患者为100%。
非手术治疗及内淋巴囊减压或引流可改善眩晕并提高生活质量。前庭神经切断术和迷路切除术是消除眩晕的有效手术治疗方法。梅尼埃病的治疗取决于多个因素：眩晕和听力的分期、生活质量、手术禁忌证及患者主观意愿。因此，梅尼埃病的治疗必须针对每位患者进行个体化。
