Department of Otolaryngology and Head and Neck Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan.
Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Sci Rep. 2022 Dec 1;12(1):20782. doi: 10.1038/s41598-022-25321-z.
Ménière's disease (MD) is an inner ear disorder in which the main pathological feature is endolymphatic hydrops (EH). Positive pressure therapy (PPT) using a portable device is now a second-line therapy for intractable MD when initial medical treatment fails. However, it remains unknown whether PPT causes the morphological and functional changes of inner ear in patients with active MD in accordance with reduction of vertigo attacks. In this nonrandomized controlled trial of 52 patients with MD, the volume of EH significantly decreased with reduction of vertigo attacks during 8 months of PPT combined with medications while the volume of that significantly increased with medications alone. There was no difference between Control group (n = 26) and PPT group (n = 26) regarding the vertigo control, however, PPT group achieved a significant functional improvement of vertical semicircular canals. The effect of volume reduction by PPT has been firstly demonstrated and the functional changes of all semicircular canals during PPT have been firstly examined. Morphological and functional changes in the inner ear by administrating local positive pressure are quite different from those caused by medications alone.Clinical trial registration: UMIN-CTR UMIN000041164 (registered on July 20, 2020).
梅尼埃病（MD）是一种内耳疾病，其主要病理特征是内淋巴积水（EH）。当初始药物治疗失败时，使用便携式设备的正压治疗（PPT）现在是治疗难治性 MD 的二线治疗方法。然而，目前尚不清楚 PPT 是否会导致伴有眩晕发作的活动期 MD 患者的内耳形态和功能发生变化，以减少眩晕发作。在这项对 52 例 MD 患者进行的非随机对照试验中，在 PPT 联合药物治疗的 8 个月期间，EH 体积随着眩晕发作的减少而显著减少，而在单独使用药物治疗期间，EH 体积显著增加。虽然在眩晕控制方面，对照组（n=26）与 PPT 组（n=26）之间没有差异，但 PPT 组实现了垂直半规管的显著功能改善。本研究首次证明了 PPT 通过减少 EH 体积的效果，并首次检查了 PPT 期间所有半规管的功能变化。局部正压给药对内耳的形态和功能变化与单独使用药物引起的变化有很大不同。
