Yamazaki T, Hayashi M, Hayashi N, Kozaki H
Department of Neurotology, Sapporo City General Hospital, Japan.
Arch Otorhinolaryngol. 1988;245(3):170-4. doi: 10.1007/BF00464021.
In 1974, six patients with incapacitating unilateral Menière's disease were given an empiric treatment with intratympanic gentamycin sulfate via the eustachian tube using a tubal catheter with a small side-branch. These patients then showed excellent results with relief from vertigo over a 13-year period. Since 1980, we have treated patients suffering from Menière's disease with isosorbide. When patients could not be controlled with this therapy, isosorbide was given in addition to intratympanic gentamycin therapy using a tubal catheter. Of 75 patients with Menière's disease who received gentamycin and isosorbide therapy, 41 patients could be evaluated by the classification for Menière's disease proposed by the American Academy of Ophthalmology and Otolaryngology (AAOO). Subsequent results showed that vertigo improved in 73% of the patients. According to the AAOO classification, 11 patients (27%) were group A, 16 patients (39%) were group B, and 4 patients (10%) were group C. Eleven patients were group D (27%) and experienced persistent vertigo despite treatment. Our experiences show that patients with severe Menière's disease can be readily treated with intratympanic gentamycin therapy using a tubal catheter, even on an outpatient basis. This treatment is also a most effective treatment, as it allows the effects of isosorbide to be obtained with smaller doses of gentamycin sulfate.
1974年，6例单侧梅尼埃病导致功能障碍的患者通过咽鼓管使用带有小侧支的输卵管导管接受了鼓室内注射硫酸庆大霉素的经验性治疗。这些患者在13年期间眩晕症状得到缓解，效果极佳。自1980年以来，我们用异山梨醇治疗梅尼埃病患者。当这种疗法无法控制病情时，除了使用输卵管导管进行鼓室内庆大霉素治疗外，还会给予异山梨醇。在75例接受庆大霉素和异山梨醇治疗的梅尼埃病患者中，41例患者可根据美国眼耳鼻喉科协会（AAOO）提出的梅尼埃病分类进行评估。后续结果显示，73%的患者眩晕症状有所改善。根据AAOO分类，11例患者（27%）为A组，16例患者（39%）为B组，4例患者（10%）为C组。11例患者为D组（27%），尽管接受了治疗仍持续眩晕。我们的经验表明，即使在门诊，严重梅尼埃病患者也可通过使用输卵管导管进行鼓室内庆大霉素治疗轻易得到治疗。这种治疗也是一种非常有效的治疗方法，因为它能以较小剂量的硫酸庆大霉素获得异山梨醇的效果。
