Zhang Daogong, Lv Yafeng, Li Xiaofei, Song Yongdong, Kong Ligang, Fan Zhaomin, Wang Haibo
Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Front Neurol. 2022 Mar 11;13:827462. doi: 10.3389/fneur.2022.827462. eCollection 2022.
To explore the long-term efficacy and safety of resection of the lateral wall of the endolymphatic sac for the treatment of intractable Meniere's disease (MD) as an alternative surgical procedure for treating this disorder.
Data from 73 patients who were referred to our hospital and diagnosed with unilateral MD between January 2015 and June 2019 were retrospectively analyzed in this study. Seventy-three patients who had frequent vertigo even after receiving standardized conservative treatment for at least half a year underwent resection of the lateral wall of the endolymphatic sac. Vertigo control and auditory function were assessed. Pure tone audiometry, caloric test, and vestibular evoked myogenic potential were performed to evaluate audiological and vestibular functions. The post-operative follow-up duration was more than 2 years.
Among the 73 patients (male 34 cases, female 39 cases; age 20-69 years, average 51.4), vertigo was controlled effectively for 66 cases (90.4%) after 2 years of follow-up; 45 cases (61.6%) were completely controlled, and 21 cases (28.8%) were substantially controlled in this study. The patients of 16.4% had hearing loss with more than 10 dB change based on the four-tone average (0.5, 1, 2 and 3 kHz). No patient had a facial nerve weakness, cerebrospinal fluid leakage, or other complications.
Resection of the lateral wall of the endolymphatic sac, which can effectively control vertiginous symptoms in intractable MD patients, represents an effective and safe therapy for this disease. Resection of the lateral wall of the endolymphatic sac is expected to be used as an alternative treatment for MD.
探讨内淋巴囊外侧壁切除术治疗难治性梅尼埃病(MD)的长期疗效及安全性,作为治疗该疾病的一种替代手术方法。
本研究回顾性分析了2015年1月至2019年6月期间转诊至我院并诊断为单侧MD的73例患者的数据。73例患者在接受至少半年的标准化保守治疗后仍频繁眩晕,接受了内淋巴囊外侧壁切除术。评估眩晕控制情况和听觉功能。进行纯音听力测定、冷热试验和前庭诱发肌源性电位以评估听力学和前庭功能。术后随访时间超过2年。
73例患者(男性34例,女性39例;年龄20 - 69岁,平均51.4岁)中,随访2年后66例(90.4%)眩晕得到有效控制;本研究中45例(61.6%)完全控制,21例(28.8%)基本控制。16.4%的患者基于四频率平均(0.5、1、2和3kHz)听力损失超过10dB。无患者出现面神经麻痹、脑脊液漏或其他并发症。
内淋巴囊外侧壁切除术可有效控制难治性MD患者的眩晕症状,是治疗该疾病的一种有效且安全的方法。内淋巴囊外侧壁切除术有望作为MD的一种替代治疗方法。