Issa T K, Bahgat M A, Linthicum F H, House H P
Am J Otol. 1983 Apr;4(4):323-6.
To determine new guidelines for stapedectomy in patients with both Meniere's disease and otosclerosis, we studied the position of the saccular membrane and Reissner's membrane in relation to the stapes footplate in eight temporal bones from patients with Meniere's disease. We also reviewed charts of four patients with both otosclerosis and Meniere's disease who had stapedectomy. Histologic and clinical findings were compared with preoperative bone conduction levels at 500 Hz and at high frequencies. We found that the saccular and Reissner's membranes did not contact the stapes footplate ain bones of patients with preoperative bone conduction levels of 35 dB or better at 500 Hz and no high-frequency loss. We also found that stapedectomy was successful in patients with the same criteria. We therefore conclude that stapedectomy does not increase the risk of sensorineural hearing loss for patients with otosclerosis and Meniere's disease who have bone conduction levels of 35 dB o better at 500 Hz and no high-tone loss, but it is contraindicated for patients with 45 dB at 500 Hz or worse and with high-tone loss.
为确定梅尼埃病和耳硬化症患者行镫骨切除术的新指南，我们研究了8例梅尼埃病患者颞骨中球囊膜和Reissner膜相对于镫骨足板的位置。我们还回顾了4例同时患有耳硬化症和梅尼埃病且接受了镫骨切除术患者的病历。将组织学和临床结果与术前500Hz及高频的骨导水平进行比较。我们发现，术前500Hz骨导水平为35dB或更高且无高频听力损失的患者，其球囊膜和Reissner膜未与镫骨足板接触。我们还发现，符合相同标准的患者镫骨切除术成功。因此，我们得出结论，对于500Hz骨导水平为35dB或更高且无高音听力损失的耳硬化症和梅尼埃病患者，镫骨切除术不会增加感音神经性听力损失的风险，但对于500Hz为45dB或更差且有高音听力损失的患者则为禁忌。
