Loader Benjamin, Beicht David, Hamzavi Jafar-Sasan, Franz Peter
Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Vienna, Vienna General Hospital, Austria.
Acta Otolaryngol. 2012 May;132(5):491-7. doi: 10.3109/00016489.2011.642815. Epub 2011 Dec 27.
Because the presented data reveal an immediate and persistent reduction of vertigo and a clear improvement in hearing function and functional scales, we conclude tenotomy to be effective in unilateral, definite Meniere's disease - laying the foundation for future prospective, randomized controlled trials.
This study compares the unique long-term results of tenotomy of the stapedius and tensor tympani muscles in definite Meniere's disease refractory to medical treatment and presents a hypothesis on why tenotomy seems effective.
This was an interventional cohort study. The study sample comprised 30 patients (15 males, 15 females; average age 57 ± 13.1 years) with definite Meniere's disease (AAO-HNS criteria, 1995). Patients were evaluated pre- and postoperatively using pure tone audiometry, AAO-HNS questionnaires regarding vertigo attacks, functional level scores, and tinnitus, and were followed up for 2-9 years. Postoperative values were calculated for the patient collective as a whole and consequently divided into three equal postoperative terms of 3 years each.
A statistically significant improvement of inner ear hearing levels postoperatively (p = 0.041) and a major reduction in vertigo attacks in all groups (p < 0.001) with complete absence of attacks in 26/30 patients was noted. Results remained constant up to 9 years postoperatively. Although tinnitus persisted, the intensity was lower overall (p = 0.013).
由于所呈现的数据显示眩晕立即且持续减轻，听力功能和功能量表有明显改善，我们得出结论，对于单侧明确的梅尼埃病，镫骨肌和鼓膜张肌切断术是有效的——为未来的前瞻性随机对照试验奠定了基础。
本研究比较了在药物治疗无效的明确梅尼埃病中镫骨肌和鼓膜张肌切断术独特的长期效果，并提出了关于为什么切断术似乎有效的假设。
这是一项干预性队列研究。研究样本包括30例（15例男性，15例女性；平均年龄57±13.1岁）明确的梅尼埃病患者（按照1995年美国耳鼻咽喉头颈外科学会标准）。患者在术前和术后使用纯音听力测定、美国耳鼻咽喉头颈外科学会关于眩晕发作、功能水平评分和耳鸣的问卷进行评估，并随访2至9年。对整个患者群体计算术后值，并因此将其分为三个相等的术后阶段，每个阶段3年。
术后内耳听力水平有统计学显著改善（p = 0.041），所有组眩晕发作大幅减少（p < 0.001），30例患者中有26例完全没有发作。术后9年结果保持不变。虽然耳鸣持续存在，但总体强度较低（p = 0.013）。
