Martin-Sanz Eduardo, Esteban-Sanchez Jonathan, Rodrigañez-Riesco Laura, Sanz-Fernández Ricardo
Department of Otolaryngology, University Hospital of Getafe, Madrid, Spain.
Laryngoscope. 2015 May;125(5):1183-8. doi: 10.1002/lary.25057. Epub 2014 Nov 28.
OBJECTIVES/HYPOTHESIS: This study aimed to evaluate the changes in electrocochleography (EcohG) measurements after intratympanic (IT) dexamethasone therapy and to correlate them with the long-term effects on the control of vertigo.
Prospective outcomes research.
This study included 62 patients with unilateral Ménière's Disease (MD) refractory to medical therapy for at least 1 year. Each patient was treated with a fixed protocol of three consecutive weekly injections of a commercial 4 mg/mL dexamethasone preparation. The 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria for reporting treatment outcomes for MD were used. Electrocochleography (EcohG) measurements were performed 1 month before and 1 and 12 months after IT steroid therapy. Caloric test and vestibular evoked myogenic potential (VEMPs) were performed before the IT treatment. The summating potential/action potential (SP/AP) ratio was measured before and after the IT treatment. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period.
Complete vertigo control (class A) was achieved in 26 patients (41.9%) at the 12-month follow-up and in 12 patients (19.3%) at the 24-month follow-up. A significant reduction (P < 0.01) in the SP/AP ratio after the IT steroid treatment was observed in the first-month determination, but no significant differences were found when the initial and 12-month determination were compared.
IT dexamethasone provides an alternative treatment for patients with Ménière's Disease. A transitory reduction of the endolymphatic hydrops is detected by the EcohG 1 month after treatment. The hydrops levels returned to their initial values in the 1-year EcohG follow-up.
2b.
目的/假设：本研究旨在评估鼓室内注射地塞米松治疗后电耳蜗图（EcohG）测量值的变化，并将其与眩晕控制的长期效果相关联。
前瞻性结果研究。
本研究纳入62例单侧梅尼埃病（MD）患者，这些患者接受至少1年的药物治疗无效。每位患者接受连续3周每周1次的固定方案治疗，注射市售4mg/mL地塞米松制剂。采用1995年美国耳鼻咽喉头颈外科学会（AAO-HNS）报告MD治疗结果的标准。在鼓室内注射类固醇治疗前1个月以及治疗后1个月和12个月进行电耳蜗图（EcohG）测量。在鼓室内治疗前进行冷热试验和前庭诱发肌源性电位（VEMP）检查。测量鼓室内治疗前后的总和电位/动作电位（SP/AP）比值。采用Kaplan-Meier分析评估2年期间的眩晕控制情况。
在12个月随访时，26例患者（41.9%）实现了完全眩晕控制（A级），在24个月随访时，12例患者（19.3%）实现了完全眩晕控制。在第一个月的测定中，观察到鼓室内注射类固醇治疗后SP/AP比值显著降低（P<0.01），但比较初始测定和12个月测定时未发现显著差异。
鼓室内注射地塞米松为梅尼埃病患者提供了一种替代治疗方法。治疗1个月后，EcohG检测到内淋巴积水暂时减轻。在EcohG随访1年时，积水水平恢复到初始值。
2b。
