Sbeih Firas, Christov Florian, Gluth Michael B
1 University of Central Florida College of Medicine, Orlando, Florida, USA.
2 University of Chicago Section of Otolaryngology-Head & Neck Surgery and Universitaetsklinikum Essen, Department of ENT-HNS, Essen, Germany.
Ann Otol Rhinol Laryngol. 2018 May;127(5):331-337. doi: 10.1177/0003489418763224. Epub 2018 Mar 16.
To describe the course of Meniere's disease with noninvasive treatment during the first few years after initial diagnosis.
A retrospective review of consecutive patients with newly diagnosed definite Meniere's disease between 2013 and 2016 and a minimum follow-up of 1 year. Patients received a written plan for low sodium, water therapy, and treatment with a diuretic and/or betahistine. Subjects were screened and treated for vestibular migraine as needed. Vertigo control and hearing status at most recent follow-up were assessed.
Forty-four subjects had an average follow up of 24.3 months. Thirty-four percent had Meniere's disease and vestibular migraine, and 84% had unilateral Meniere's disease. Seventy-five percent had vertigo well controlled at most recent follow-up, with only noninvasive treatments. Age, gender, body mass index, presence of vestibular migraine, bilateral disease, and duration of follow-up did not predict noninvasive treatment failure. Worse hearing threshold at 250 Hz and lower pure tone average (PTA) at the time of diagnosis did predict failure. Fifty-two percent of ears had improved PTA at most recent visit, 20% had no change, and 28% were worse Conclusions: Encountering excellent vertigo control and stable hearing after a new diagnosis of Meniere's disease is possible with noninvasive treatments. Worse hearing status at diagnosis predicted treatment failure.
描述梅尼埃病初诊后最初几年采用非侵入性治疗的病程。
对2013年至2016年间新诊断为明确梅尼埃病且至少随访1年的连续患者进行回顾性研究。患者接受低钠、水疗法以及利尿剂和/或倍他司汀治疗的书面方案。根据需要对受试者进行前庭性偏头痛筛查和治疗。评估最近一次随访时的眩晕控制情况和听力状态。
44名受试者的平均随访时间为24.3个月。34%的患者患有梅尼埃病和前庭性偏头痛，84%的患者患有单侧梅尼埃病。75%的患者在最近一次随访时眩晕得到良好控制，仅采用了非侵入性治疗。年龄、性别、体重指数、前庭性偏头痛的存在、双侧疾病以及随访时间并不能预测非侵入性治疗失败。诊断时250Hz听力阈值较差和纯音平均听阈（PTA）较低确实可预测治疗失败。52%的患耳在最近一次就诊时PTA有所改善，20%无变化，28%变差。结论：梅尼埃病新诊断后采用非侵入性治疗有可能实现出色的眩晕控制和听力稳定。诊断时听力状态较差预示治疗失败。
