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三半规管阻塞术后梅尼埃病前庭症状的变化:一项长期随访研究

Changes of Vestibular Symptoms in Menière's Disease After Triple Semicircular Canal Occlusion: A Long-Term Follow-Up Study.

作者信息

Jiang Yumeng, Xu Maoxiang, Yao Qingxiu, Li Zhuangzhuang, Wu Yaqin, Chen Zhengnong, Yu Dongzhen, Shi Haibo, Yin Shankai

机构信息

Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Neurol. 2022 Feb 4;13:797699. doi: 10.3389/fneur.2022.797699. eCollection 2022.

Abstract

BACKGROUND

The clinical efficacy of triple semicircular canal occlusion (TSCO) and vestibular nerve resection (VNS) for patients with Ménière's disease has been unclear.

OBJECTIVE

To explore changes in vestibular symptoms after TSCO and its advantages compared to the classical operation of VNS in patients with Menière's disease.

METHODS

In total, 36 patients with Menière's disease performed TSCO or VNS at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China from May 2005 to July 2021, and all of them were enrolled in our study. Twelve of them underwent TSCO, 23 underwent VNS, and 1 had both treatments. We compared the demographic parameters, clinical symptoms, and selected test results between the two surgical methods. Ten patients each who underwent TSCO and VNS completed the follow-up. We collected and compared data pertaining to changes in vestibular symptoms.

RESULTS

No significant difference in demographic parameters, clinical symptoms, or auditory or vestibular test results was detected between the two groups preoperatively. The TSCO group with vertigo as the main complaint experienced less residual paroxysmal dizziness after surgery than the VNS group ( = 0.020). Also, 57% of the patients in the VNS group had unsteadiness after surgery, while no such problems were reported in the TSCO group ( = 0.025).

CONCLUSIONS

Our study shows that TSCO controls vertigo in most Menière's disease patients, and also has the advantage of lower rates of postoperative paroxysmal dizziness and unsteadiness than VNS. Thus, TSCO may be an effective surgery for refractory Menière's disease.

摘要

背景

对于梅尼埃病患者,三半规管阻塞术(TSCO)和前庭神经切除术(VNS)的临床疗效尚不清楚。

目的

探讨TSCO术后前庭症状的变化及其与经典手术VNS相比在梅尼埃病患者中的优势。

方法

2005年5月至2021年7月,共有36例梅尼埃病患者在中国上海交通大学附属第六人民医院接受了TSCO或VNS手术,所有患者均纳入本研究。其中12例接受了TSCO,23例接受了VNS,1例接受了两种治疗。我们比较了两种手术方法的人口统计学参数、临床症状和选定的检查结果。分别有10例接受TSCO和VNS的患者完成了随访。我们收集并比较了与前庭症状变化相关的数据。

结果

两组术前的人口统计学参数、临床症状或听觉及前庭检查结果均无显著差异。以眩晕为主诉的TSCO组术后残余阵发性头晕少于VNS组(P = 0.020)。此外,VNS组57%的患者术后有步态不稳,而TSCO组未报告此类问题(P = 0.025)。

结论

我们的研究表明,TSCO能控制大多数梅尼埃病患者的眩晕,且与VNS相比,术后阵发性头晕和步态不稳的发生率较低。因此,TSCO可能是治疗难治性梅尼埃病的一种有效手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/371d/8854354/3feb9bb5854a/fneur-13-797699-g0001.jpg

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