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经鼓室置管后梅尼埃病症状改善:初步观察。

Symptom improvement after transtympanic tube placement in Ménière's disease: preliminary observations.

机构信息

UOC ENT Ospedale del Mare, Naples, Italy.

ENT Clinica Santa Patrizia, Naples, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2021 Oct;41(5):467-473. doi: 10.14639/0392-100X-N1705.

Abstract

OBJECTIVE

The treatment of choice for Ménière disease (MD) aims at preventing severity and frequency of vertigo attacks. The purpose of this study was to evaluate the effectiveness of ventilation tube (VT) placement on vertigo control in patients affected by MD with no response to standard medical therapy.

METHODS

76 consecutive outpatients diagnosed with definite MD who failed medical therapy received VT insertion at the Department of Otolaryngology Head and Neck Surgery, "Ospedale del Mare", Naples, Italy, with a 3-year follow up.

RESULTS

Over the long term, VT placement was effective in controlling vertigo in 61.8% of patients. In the control group treated with standard preventive care (SPC) alone, all patients continued to experience recurrent vertigo during the entire study. Comparison of survival curves by using the log-rank test shows that significant differences in survival exist between subjects treated with VT placement and the control sample (p = 0.001).

CONCLUSIONS

Our long-term follow-up confirms that VT placement is an effective and safe management option in intractable definite MD, especially in the elderly or in those refusing more invasive treatments.

摘要

目的

梅尼埃病(MD)的治疗选择旨在预防眩晕发作的严重程度和频率。本研究旨在评估通气管(VT)放置对标准药物治疗反应不佳的 MD 患者眩晕控制的有效性。

方法

意大利那不勒斯“Ospedale del Mare”耳鼻喉头颈外科连续收治 76 例确诊 MD 的门诊患者,这些患者在药物治疗失败后接受 VT 插入治疗,并进行为期 3 年的随访。

结果

从长期来看,VT 放置对 61.8%的患者有效控制眩晕。在仅接受标准预防护理(SPC)的对照组中,所有患者在整个研究期间持续出现复发性眩晕。使用对数秩检验比较生存曲线表明,VT 放置组和对照组之间的生存存在显著差异(p=0.001)。

结论

我们的长期随访证实,VT 放置是一种有效且安全的管理选择,尤其是在难以治疗的明确 MD 患者中,特别是在老年患者或拒绝更具侵袭性治疗的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34d4/8569656/2dca15973868/aoi-2021-05-467-g001.jpg

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