Silverstein H
Laryngoscope. 1978 Oct;88(10):1603-11. doi: 10.1288/00005537-197810000-00006.
Preoperative vestibular function was studied in 56 patients undergoing the endolymphatic subarachnoid shunt procedure for Ménière's disease by electronystagmographic recording of bithermal air caloric stimulation. Fifty-two percent had normal vestibular function while 48% had a reduced vestibular response on the affected side using 20% difference as being significant. Best results of surgery with relief of vertigo were found in the group of patients with normal preoperative vestibular function (82%) while the group with reduced vestibular response preoperatively showed 63% with a good result. Postoperatively, 81% had a reduced vestibular response in the operated-on ear with 62% obtaining relief of vertigo. In patients with normal vestibular function postoperatively excellent relief of vertigo was obtained. Of patients with normal vestibular function preoperatively, 69% developed a reduced vestibular response postoperatively with only 55% having relief of vertigo. The results of surgery could be predicted more accurately using the results of vestibular function tests than audiometric data. It appears that for best results the endolymphatic subarachnoid shunt procedure should be performed early in the course of Ménière's disease when hearing is fluctuating and vestibular function is normal.
对56例因梅尼埃病接受内淋巴囊蛛网膜下腔分流术的患者，通过双温空气热量刺激的眼震电图记录来研究术前前庭功能。52%的患者前庭功能正常，而以20%的差异为显著标准时，48%的患者患侧前庭反应降低。术前前庭功能正常的患者组手术缓解眩晕的效果最佳（82%），而术前前庭反应降低的组显示63%效果良好。术后，81%的患耳前庭反应降低，62%的患者眩晕得到缓解。术后前庭功能正常的患者眩晕得到极佳缓解。术前前庭功能正常的患者中，69%术后前庭反应降低，只有55%的患者眩晕得到缓解。与听力测定数据相比，使用前庭功能测试结果能更准确地预测手术效果。似乎为了获得最佳效果，内淋巴囊蛛网膜下腔分流术应在梅尼埃病病程早期进行，此时听力波动且前庭功能正常。
