Macedonian Academy of Sciences and Arts, Skopje, RN Macedonia.
University Clinic for Otorhinolaryngology, Faculty of Medicine, University Ss. Cyril and Methodius, Skopje, RN Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Apr 23;42(1):141-148. doi: 10.2478/prilozi-2021-0012.
: To evaluate the efficiency and safety of the simultaneous endolymphatic sac drainage (ELSD) and posterior semicircular canal fenestration (PSCF) primary on the vestibular function as an new therapeutic strategy in the patients with medically refractory Meniere's disease (MD).: retrospective follow-up study.: University Clinic of Otolaryngology.: Twenty-six patients with MD with severe vertigo and disability who underwent ELSD and PSCF in the same time in the period of 1988 and 2007 were reviewed. The main outcome measures were frequency of vertigo, functional disability according the guidelines for diagnosis and evaluation of therapy in MD. The canal paresis was evaluated by caloric test. The degree of reduced vestibular response rates as an indicators of the vestibular function were compared before and after surgery.: The preoperative audition was already altered in all cases except in 8 patients who had no significant changes in hearing threshold. The mean value of vertigo attacks before operation was 8.6. After 3 years of surgery only one patient (3.8%) had one vertigo attack. Functional level was highly ameliorated except in two patients who presented functional level 2 or B in the late postoperative period. The mean caloric testing duration after 3 years postoperatively showed that the 50% of the patients approaching the normal results.: Based on the results of simultaneous endolymphatic sac surgery and posterior canal fenestration, they are effective methods for treatment of the refractory Meniere's disease. Endolymphatic sac surgery enables drainage of endolymphatic fluid and the fenestration of the posterior semicircular canal enables the distension or dilatation of the membranous canal in the decompressed perilymphatic space across the perilymphatic leak at the level of the new fenestra, and, so, appearing of certain decrease of the endolymphatic pressure. Both techniques at the same time decrease the pressure in the case of the endolymphatic hydrops.
: 评估同时行内淋巴囊引流（ELSD）和后半规管开窗术（PSCF）对前庭功能的疗效和安全性，作为一种新的治疗策略，用于治疗药物难治性梅尼埃病（MD）患者。: 回顾性随访研究。: 耳鼻喉科大学诊所。: 1988 年至 2007 年间，对 26 例 MD 伴严重眩晕和失能患者同时行 ELSD 和 PSCF 治疗，进行回顾性分析。主要观察指标为眩晕发作频率、根据 MD 诊断和治疗评估指南评估的功能障碍。通过冷热试验评估管麻痹。比较手术前后前庭功能减退的程度，以评估前庭功能。: 所有病例术前听力均已改变，除 8 例听力阈值无明显变化外。术前平均眩晕发作次数为 8.6 次。术后 3 年，仅 1 例（3.8%）出现 1 次眩晕发作。功能水平显著改善，除 2 例术后晚期功能水平为 2 或 B 外。术后 3 年冷热试验平均持续时间显示，50%的患者接近正常结果。: 基于同时行内淋巴囊手术和后管开窗术的结果，它们是治疗难治性梅尼埃病的有效方法。内淋巴囊手术可引流内淋巴液，后管开窗术可使膜性半规管在后半规管膨胀或扩张，从而使通过新开窗处的漏口在减压的外淋巴间隙中扩张或扩张，因此内淋巴液压力出现一定程度的降低。这两种技术同时降低内淋巴积水的压力。
