Furukawa Masashi, Kitahara Tadashi, Horii Arata, Uno Atsuhiko, Imai Takao, Ohta Yumi, Morihana Tetsuo, Inohara Hidenori, Mishiro Yasuo, Sakagami Masafumi
Department of Otolaryngology-Head and Neck Surgery, Osaka University School of Medicine, Osaka, Japan.
Acta Otolaryngol. 2013 Jun;133(6):584-9. doi: 10.3109/00016489.2012.759274.
Physicians should consider additional treatment strategies for Meniere's disease patients with a long history of disease and hearing loss in the secondary affected ear and also provide psychological support regarding future progressive bilateral hearing loss.
To treat intractable Meniere's disease patients effectively, we need to understand the psychological condition of each patient. We examined the state of neurosis and depression in patients and correlated this with demographic and background information.
Between 1998 and 2009, we enrolled 207 patients with intractable Meniere's disease in this prospective study. We used the Cornell Medical Index and the Self-rating Depression Scale to evaluate their psychological condition. We also obtained demographic and background information relating to sex, age, duration of disease, vertigo frequency, hearing level in bilateral sides, and plasma vasopressin level.
Neurosis and depression was diagnosed in 40.1% and 60.4%, respectively, of patients with intractable Meniere's disease. Our results showed that surgical treatment significantly improved vertigo and hearing ability in patients with no psychological symptoms compared with those exhibiting psychological symptoms. Patients with a longer duration and worse hearing level in the secondary affected ear had a significantly higher incidence of mental illness than those with a shorter duration and better level of hearing.
对于患梅尼埃病时间长且患侧耳听力丧失的患者,医生应考虑额外的治疗策略,并就未来可能出现的双侧进行性听力丧失提供心理支持。
为了有效治疗难治性梅尼埃病患者,我们需要了解每位患者的心理状况。我们研究了患者的神经症和抑郁状态,并将其与人口统计学和背景信息相关联。
在1998年至2009年期间,我们将207例难治性梅尼埃病患者纳入了这项前瞻性研究。我们使用康奈尔医学指数和自评抑郁量表来评估他们的心理状况。我们还获取了与性别、年龄、病程、眩晕频率、双侧听力水平以及血浆血管加压素水平相关的人口统计学和背景信息。
难治性梅尼埃病患者中,分别有40.1%和60.4%被诊断患有神经症和抑郁症。我们的结果表明,与有心理症状的患者相比,手术治疗对没有心理症状的患者的眩晕和听力改善效果显著。病程较长且患侧耳听力水平较差的患者患精神疾病的发生率明显高于病程较短且听力水平较好的患者。