Xiong Wei, Xu Xianrong, Zhang Yang, Zheng Jun, Liu Hongjin, Xu Shuxuan, Fu Zhaojun, Liu Jing, Cui Li
Center of Clinical Aviation Medicine, Air Force General Hospital, PLA, Beijing 100142, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jan;27(1):16-9.
To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.
Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.
Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.
The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
了解飞行人员梅尼埃病的临床特点,探讨临床航空医学的相关原则,总结飞行人员医学鉴定经验。
收集我院1966年至2011年确诊为梅尼埃病的35例患者资料,分析其临床特点、诊断及飞行结论。
35例中,34例有眩晕主诉,27例有耳鸣主诉,21例有听力下降主诉。(1)18例表现为典型的梅尼埃病症状(阵发性眩晕、波动性感音神经性听力下降、耳鸣及耳胀满感);(2)7例有眩晕、耳鸣症状,无明显听力下降主诉(检查后4例证实有低频听力下降);(3)7例仅表现为眩晕;(4)2例表现为耳鸣、听力下降,1例仅表现为听力下降。按照美国耳鼻咽喉-头颈外科学会听力与平衡委员会制定的梅尼埃病诊断标准,确诊梅尼埃病22例,可能梅尼埃病2例,可疑梅尼埃病11例。确诊及可能梅尼埃病患者中,Ⅰ期11例,Ⅱ期7例,Ⅲ期6例。35例患者飞行结论均为永久停飞。发病至永久停飞结论时间为3个月至11年不等。
飞行人员梅尼埃病的诊断必须谨慎。对于梅尼埃病非典型症状患者,应在完全排除其他可能疾病后作出诊断。一旦确诊,通常飞行不合格。仅在特殊情况下可考虑飞行豁免,豁免条件标准今后需进一步探索。