Dornhoffer J L
Department of Otolaryngology, University of Arkansas for Medical Sciences, Little Rock, Ark., USA.
ORL J Otorhinolaryngol Relat Spec. 1998 Nov-Dec;60(6):301-5. doi: 10.1159/000027614.
The existence of cochlear Ménière's disease, once considered a variant of classic Ménière's disease but without vertigo, has been questioned due to lack of objective evidence that endolymphatic hydrops is involved with the disease process. Transtympanic electrocochleography (TT ECoG) has emerged as a useful tool for electrophysiologic monitoring of the inner ear, and is especially valuable in assessing endolymphatic hydrops. A retrospective chart review was performed to identify those patients with a diagnosis consistent with cochlear Ménière's disease in order to determine the presence or absence of endolymphatic hydrops using TT ECoG. A total of 7 patients were identified with at least a 2-year follow-up. Using established norms for the summating potential to action potential ratio with click stimulus, 67% of the ears examined demonstrated values consistent with endolymphatic hydrops. Fluctuating aural pressure and tinnitus were present in all patients and medical therapy of diuretics and salt restriction seemed to stabilize or improve the condition in about 80% of the patients. Theoretical considerations are discussed, and a case history of 1 of the study patients is presented to illustrate a typical example of this variant of Ménière's disease.
耳蜗性梅尼埃病曾被认为是经典梅尼埃病的一种变体，但无眩晕症状，由于缺乏内淋巴积水参与疾病过程的客观证据，其存在受到质疑。经鼓膜电耳蜗图（TT ECoG）已成为内耳电生理监测的一种有用工具，在评估内淋巴积水方面尤其有价值。进行了一项回顾性病历审查，以确定那些诊断符合耳蜗性梅尼埃病的患者，以便使用TT ECoG确定内淋巴积水的存在与否。共确定了7例患者，至少随访2年。根据既定的短声刺激下总和电位与动作电位比值标准，67%接受检查的耳显示出与内淋巴积水一致的值。所有患者均有波动性耳内压和耳鸣，利尿剂和限盐的药物治疗似乎使约80%的患者病情稳定或改善。讨论了理论考量，并给出了1例研究患者的病史，以说明这种梅尼埃病变体的典型例子。
