Covelli Edoardo, Volpini Luigi, Atturo Francesca, Benincasa Anna Teresa, Filippi Chiara, Tarentini Silvia, Marrone Vania, Monini Simonetta, Vestri Annarita, Barbara Maurizio
NESMOS Department, Otolaryngology Clinic, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Audiol Neurootol. 2017;22(1):24-29. doi: 10.1159/000472245. Epub 2017 May 18.
To identify eventual correlations between the effect of low-pressure treatment and endolymphatic hydrops in Ménière patients.
The study group consisted of subjects affected by definite Ménière disease (2015) and a severe degree of disability, who received a ventilation tube with or without a low-pressure treatment before undergoing a surgical procedure (vestibular neurectomy). After the placement of the ventilation tube, the subjects were either left alone with the tube or received 1 month of self-administered low-pressure therapy with a portable device. In all subjects, an electrocochleography (ECochG) was performed and specific questionnaires - Dizziness Handicap Inventory (DHI) and Functional Scale Level (FSL) - were completed before starting either arm of treatment, at the end of treatment, and then 3 and 6 months later.
All selected subjects presented with an ECochG pattern that was indicative of endolymphatic hydrops before starting either treatment. At the end of pressure treatment, 80% showed symptomatic improvement while maintaining the hydropic ECochG pattern. At the 3-month control stage, the hydropic pattern resulted normalized (<0.5) in all the improved subjects.
Although 1 month of low-pressure treatment provided a positive symptomatological outcome, normalization of the hydropic ECochG parameters occurred only at a later time. Therefore, it is possible to assume that endolymphatic hydrops could be concurrent with a non-symptomatic stage of Ménière disease, and that the anti-hydropic effect of the low-pressure treatment, if any, would present with a certain delay after its completion.
确定低压治疗效果与梅尼埃病患者内淋巴积水之间的潜在相关性。
研究组由确诊为梅尼埃病（2015年）且残疾程度严重的受试者组成，他们在接受手术（前庭神经切除术）前接受了带或不带低压治疗的通气管植入。通气管植入后，受试者要么仅保留通气管，要么使用便携式设备接受1个月的自我低压治疗。在所有受试者中，在治疗的任何一个阶段开始前、治疗结束时以及之后3个月和6个月时进行了耳蜗电图（ECochG）检查，并完成了特定问卷——眩晕残障量表（DHI）和功能量表水平（FSL）。
所有入选受试者在开始任何一种治疗前的ECochG模式均表明存在内淋巴积水。在压力治疗结束时，80%的受试者症状有所改善，同时保持内淋巴积水的ECochG模式。在3个月的对照阶段，所有症状改善的受试者的积水模式均恢复正常（<0.5）。
尽管1个月的低压治疗产生了积极的症状学结果，但内淋巴积水的ECochG参数仅在后期才恢复正常。因此，可以假设内淋巴积水可能与梅尼埃病的无症状阶段同时存在，并且低压治疗的抗积水作用（如果有的话）在完成后会有一定延迟才显现。
