梅尼埃病患者的乳突和内耳测量。

Mastoid and Inner Ear Measurements in Patients With Menière's Disease.

机构信息

*Department of Otolaryngology-Head and Neck Surgery †Department of General Surgery, Detroit Medical Center, Michigan State University, Detroit ‡Department of Radiology, Michigan State University, East Lansing §Department of Otology, Neurotology, and Skull Base Surgery, Michigan Ear Institute, Farmington Hills, Michigan.

出版信息

Otol Neurotol. 2017 Dec;38(10):1484-1489. doi: 10.1097/MAO.0000000000001576.

DOI:10.1097/MAO.0000000000001576

PMID:29099441

Abstract

OBJECTIVE

To determine the relationship between radiographic temporal bone anatomy of patients with Menière's disease in medically and surgically managed populations versus controls.

STUDY DESIGN

Retrospective chart review.

SETTING

Two tertiary referral centers.

PATIENTS

Adults older than 18 years with Menière's disease treated with endolymphatic sac decompression (ESD) or medical management (non-ESD) versus controls.

INTERVENTIONS

Magnetic resonance imaging and computed tomography imaging studies of the temporal bones were reviewed by blinded radiologists.

MAIN OUTCOME MEASURES

Radiographic temporal bone dimensions were measured in Menière's disease and control patients. Age, sex, symptoms, audiogram data, academy classification of Menière's disease, and follow-up were recorded. Statistical analysis was performed to compare outcome measures across groups and demographics.

RESULTS

A total of 90 imaging studies were reviewed (ESD = 22; non-ESD = 30; control = 38). ESD and non-ESD groups had similar pure-tone averages (33.9 ± 20.6 versus 41.6 ± 22.6 dB HL; p = 0.21) and frequency of definite Menière's disease (59.1% versus 53.3%; p = 0.68). There was no significant trend between groups for any measurement. One nonsignificant trend existed in mean vestibule length, increasing from the control (5.45 ± 0.54 mm), non-ESD (5.80 ± 0.97 mm), and ESD (5.94 ± 0.81 mm) group. In a combined Menière's group, mean vestibule length was significantly greater than controls (5.86 ± 0.89 versus 5.45 ± 0.54 mm; p = 0.008) and mean vestibule width significantly less (2.99 ± 0.46 versus 3.19 ± 0.39 mm; p = 0.024).

CONCLUSION

Medical and surgical Menière's patients were similar utilizing academy classification. There was no significant trend between medical and surgical Menière's patients versus controls for any measurement. In a combined Menière's group, the longer and narrower vestibule anatomy may suggest an anatomical basis for endolymphatic hydrops.

摘要

目的

确定医学和手术治疗的梅尼埃病患者与对照组之间的颞骨放射影像学解剖之间的关系。

研究设计

回顾性图表审查。

设置

两个三级转诊中心。

患者

接受内淋巴囊减压术（ESD）或药物治疗（非 ESD）的年龄大于 18 岁的梅尼埃病成年患者与对照组。

干预措施

由盲法放射科医生对颞骨的磁共振成像和计算机断层扫描研究进行了审查。

主要观察指标

在梅尼埃病和对照组患者中测量了放射影像学颞骨尺寸。记录了年龄、性别、症状、听力图数据、梅尼埃病学院分类和随访情况。进行了统计学分析，以比较各组和人口统计学数据之间的结果测量值。

结果

共审查了 90 项影像学研究（ESD=22；非 ESD=30；对照组=38）。ESD 和非 ESD 组的纯音平均听力（33.9±20.6 与 41.6±22.6 dB HL；p=0.21）和明确梅尼埃病的频率（59.1%与 53.3%；p=0.68）相似。在任何测量中，组之间均无明显趋势。在平均前庭长度方面存在一个无统计学意义的趋势，从对照组（5.45±0.54 mm）、非 ESD 组（5.80±0.97 mm）和 ESD 组（5.94±0.81 mm）逐渐增加。在梅尼埃病综合组中，平均前庭长度明显大于对照组（5.86±0.89 与 5.45±0.54 mm；p=0.008），平均前庭宽度明显减小（2.99±0.46 与 3.19±0.39 mm；p=0.024）。