Wilson D F, Hodgson R S, Talbot J M
Portland Ear Medical Group, Oregon Health Sciences University, Portland, USA.
Am J Otol. 1997 Jan;18(1):101-6; discussion 106-7.
The objective of this study was to investigate the effects of endolymphatic sac obliteration for stabilization of progressive hearing loss in patients with the large vestibular aqueduct syndrome. This was a retrospective case review conducted at a private neurootologic office in a metropolitan area. Seven ears in six patients were subjected to surgery for obliteration of the endolymphatic sac in an effort to stabilize progressive hearing loss associated with the large vestibular aqueduct syndrome. The study population was composed of four boys and two girls 4-17 years of age. The large vestibular aqueduct was unilateral in two patients and bilateral in four patients. All seven ears demonstrated progressive sensorineural hearing loss preoperatively. Surgical tissue obliteration was performed via a transmastoid approach in seven ears. The main outcome measure was comparison of pre- and postoperative hearing levels and stability. Magnetic resonance imaging also was performed in all cases at least 6 months postoperatively to determine patency of the endolymphatic sac and vestibular aqueduct. Six of seven ears maintained stable hearing during the follow-up period, which ranged from 6 months to 6 years (mean 3.2 years). One patient showed continued progression of hearing loss postoperatively. All seven ears demonstrated continued obliteration on postoperative imaging studies. Surgical obliteration of the endolymphatic sac may stabilize hearing in patients with the large vestibular aqueduct syndrome and progressive hearing loss. These results support the theory of pressure or fluid reflux into the labyrinth as a cause of progressive hearing loss in these patients.
本研究的目的是探讨内淋巴囊闭塞术对大前庭导水管综合征患者进行性听力损失稳定化的效果。这是在大都市地区一家私立神经耳科诊所进行的一项回顾性病例分析。6例患者的7只耳朵接受了内淋巴囊闭塞手术，以稳定与大前庭导水管综合征相关的进行性听力损失。研究对象包括4名年龄在4至17岁的男孩和2名女孩。2例患者的大前庭导水管为单侧，4例为双侧。所有7只耳朵术前均表现为进行性感音神经性听力损失。7只耳朵均通过经乳突入路进行手术组织闭塞。主要观察指标是术前和术后听力水平的比较及稳定性。所有病例术后至少6个月均进行了磁共振成像，以确定内淋巴囊和前庭导水管的通畅情况。7只耳朵中的6只在6个月至6年（平均3.2年）的随访期内听力保持稳定。1例患者术后听力损失持续进展。所有7只耳朵在术后影像学检查中均显示持续闭塞。内淋巴囊手术闭塞可能使大前庭导水管综合征和进行性听力损失患者的听力稳定。这些结果支持压力或液体反流至迷路是这些患者进行性听力损失原因的理论。
