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顽固性梅尼埃病手术治疗的临床长期效果:压力治疗及针对顽固性眩晕的进一步手术治疗后的13年以上随访

Clinical long-term effects of surgical treatment for intractable Meniere's disease: a more than 13-year follow-up after pressure treatment and further surgical treatment for intractable vertigo.

作者信息

Liu Fang, Huang Weining, Chen Kai

机构信息

Department of Otolaryngology, Beijing Hospital, National Center of Gerontology, Beijing, PR China.

Department of Health Care, Beijing Hospital, National Center of Gerontology, Beijing, PR China.

出版信息

Acta Otolaryngol. 2019 Dec;139(12):1053-1057. doi: 10.1080/00016489.2019.1667532. Epub 2019 Sep 26.

Abstract

Meniere's disease appears to be a complex inner ear disorder and also remains a controversial and often difficult disease as regards determination of diagnosis, pathogenesis and especially optimal treatment. To investigate the long-term effects of progressive surgical treatment in the management of the vertigo attacks of intractable Meniere's disease. Eighteen patients with medically intractable and active Meniere's disease were opted to try Meniett pulse generator (Meniett), endolymphatic sac decompression (ESD) and triple semicircular canal occlusion (TSCO) in order to control the attacks of vertigo. Patients were indicated on the symptom report card the maximum level of vertigo, activity and stress. Of 18 patients with medically intractable and active Meniere's disease during mean 165-month follow-up, the attacks of vertigo were effectively controlled in 14 patients by Meniett (77.78%), 2 patients by Meniett and ESD (11.11%), 2 patients by Meniett, ESD and TSCO (11.11%). It is of great importance for intractable Meniere's disease to select surgically combined treatment process including Meniett, ESD and TSCO to effectively control the attacks of vertigo and a long-term follow-up.

摘要

梅尼埃病似乎是一种复杂的内耳疾病,在诊断、发病机制尤其是最佳治疗方法的确定方面,它仍然是一种存在争议且常常难以处理的疾病。为了研究渐进性手术治疗对难治性梅尼埃病眩晕发作的长期影响。选择了18例药物治疗无效且处于活动期的梅尼埃病患者,尝试使用梅尼埃脉冲发生器(Meniett)、内淋巴囊减压术(ESD)和三半规管阻塞术(TSCO)来控制眩晕发作。患者在症状报告卡上记录眩晕、活动和压力的最高水平。在平均165个月的随访期间,18例药物治疗无效且处于活动期的梅尼埃病患者中,14例通过Meniett有效控制了眩晕发作(77.78%),2例通过Meniett和ESD有效控制(11.11%),2例通过Meniett、ESD和TSCO有效控制(11.11%)。对于难治性梅尼埃病,选择包括Meniett、ESD和TSCO在内的手术联合治疗方案以有效控制眩晕发作并进行长期随访非常重要。

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