Orabi Norman A, Kellermeyer Brian M, Roberts Christopher A, Wetmore Stephen J, Cassis Adam M
West Virginia University School of Medicine Department of Otolaryngology, P.O. Box 9200, Morgantown, WV 26506, USA.
Arizona Hearing & Balance Center, 225 S Dobson Rd#1, Chandler, AZ 85224, USA.
Int J Otolaryngol. 2021 Dec 24;2021:7987851. doi: 10.1155/2021/7987851. eCollection 2021.
To explore outcomes of endolymphatic sac surgery for patients with Meniere's disease with and without the comorbid condition of migraine.
A retrospective chart review of adult patients undergoing endolymphatic sac surgery at a single tertiary care center from 1987 to 2019 was performed. All adult patients who failed medical therapy and underwent primary endolymphatic sac surgery were included. The main outcome measures were vertigo control and functional level scale (FLS) score. Patient characteristics, comorbidities, and audiometric outcomes were tracked as well.
Patients with Meniere's disease and migraine had a stronger association with psychiatric comorbidities (64.29% vs. 25.80%, =0.01), shorter duration of vertigo episodes (143 vs. 393 min, =0.02), and younger age (36.6 vs. 50.8 yr, =0.005) at the time of endolymphatic sac surgery. Postoperative pure tone averages and word recognition scores were nearly identical to preoperative baselines. Class A vertigo control (47.92%) was most common, followed by class B vertigo control (31.25%). The FLS score improved from 4.2 to 2.8 ( < 0.001). Both patients with and without migraine had classes A-B vertigo control (66.67% vs. 80.95%) without any statistically significant difference (=0.59). Of the patients who required secondary treatment (10.42%), none had migraine.
Endolymphatic sac surgery is an effective surgical intervention for Meniere's disease with and without migraine. Patients with comorbid migraine tend to be younger and present with psychiatric comorbidities.
探讨内淋巴囊手术治疗梅尼埃病伴或不伴偏头痛共病患者的疗效。
对1987年至2019年在一家三级医疗中心接受内淋巴囊手术的成年患者进行回顾性病历审查。纳入所有药物治疗失败并接受初次内淋巴囊手术的成年患者。主要观察指标为眩晕控制和功能水平量表（FLS）评分。还跟踪了患者特征、共病情况和听力结果。
梅尼埃病合并偏头痛的患者与精神共病的关联更强（64.29%对25.80%，P=0.01），内淋巴囊手术时眩晕发作持续时间更短（143对393分钟，P=0.02），且年龄更小（36.6对50.8岁，P=0.005）。术后纯音平均值和单词识别分数与术前基线几乎相同。A级眩晕控制（47.92%）最为常见，其次是B级眩晕控制（31.25%）。FLS评分从4.2提高到2.8（P<0.001）。有偏头痛和没有偏头痛的患者均有A - B级眩晕控制（66.67%对80.95%），无统计学显著差异（P=0.59）。在需要二次治疗的患者中（10.42%），无人患有偏头痛。
内淋巴囊手术是治疗梅尼埃病伴或不伴偏头痛的有效手术干预措施。合并偏头痛的患者往往更年轻且伴有精神共病。
