迷路切除术与人工耳蜗植入在梅尼埃病患者中的应用：一项系统综述
Labyrinthectomy and Cochlear Implantation in Patients With Meniere Disease: A Systematic Review.
文献信息
| PMID | 42715356 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Dimitrios Paouris |
| 作者单位 | Department of Otorhinolaryngology and Head and Neck Surgery, Clinical Research Unit in Audiology, Comenius University and University Hospital. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 尽管采取了保守治疗，梅尼埃病（MD）仍可能进展为致残性眩晕和重度听力损失。对于听力不可用的患者，迷路切除术可有效控制眩晕，而人工耳蜗植入（CI）则提供了听觉康复的潜力。本系统综述旨在评估MD患者接受迷路切除术联合CI后的听力学、前庭、耳鸣相关及术后结局。
检索数据库： MEDLINE/PubMed、Scopus和Embase。
方法： 按照PRISMA指南进行了一项系统综述，并采用定性综合。主要结局包括术后言语测听和纯音平均听阈（PTA）。次要结局包括眩晕和头晕控制、头晕障碍量表（DHI）、耳鸣障碍量表（THI）及术后并发症。
结果： 共8项研究、123只植入耳符合纳入标准，包括3项队列研究和5项病例系列。7项研究报告了同期迷路切除术和CI，4项研究描述了既往迷路切除术后序贯CI。听力学结局报告异质性较大，包括PTA、辅音-核心-辅音（CNC）或单音节词识别评分、AzBio句子识别、言语识别评分以及Bamford-Kowal-Bench（BKB）/纽约城市大学（CUNY）句子测试。大多数研究显示术后可测量到听觉获益。3项研究报告了DHI结局，通常表明低至轻度残余头晕相关障碍。3项研究报告了THI结局，提示低至轻度残余耳鸣负担。2项研究报告了手术并发症，部分队列描述了术后失衡或复发性眩晕。
结论： 对于经过严格筛选的晚期或难治性MD患者，迷路切除术联合CI可有效控制眩晕，同时实现有意义的听觉康复。
英文摘要
OBJECTIVE: Ménière disease (MD) may progress to disabling vertigo and severe hearing loss despite conservative management. In patients with nonserviceable hearing, labyrinthectomy can provide effective vertigo control, while cochlear implantation (CI) offers the potential for auditory rehabilitation. This systematic review aimed to evaluate audiological, vestibular, tinnitus-related, and postoperative outcomes following labyrinthectomy combined with CI in patients with MD.
DATABASES REVIEWED: MEDLINE/PubMed, Scopus, and Embase.
METHODS: A systematic review with qualitative synthesis was conducted in accordance with the PRISMA guidelines. Primary outcomes included postoperative speech audiometry and pure-tone average (PTA). Secondary outcomes included vertigo and dizziness control, Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), and postoperative complications.
RESULTS: Eight studies comprising 123 implanted ears met the inclusion criteria, including 3 cohort studies and 5 case series. Simultaneous labyrinthectomy and CI were reported in 7 studies, whereas 4 studies described sequential CI following prior labyrinthectomy. Audiological outcome reporting was heterogeneous and included PTA, Consonant-Nucleus-Consonant (CNC) or monosyllabic word recognition scores, AzBio sentence recognition, speech discrimination scores, and Bamford-Kowal-Bench (BKB)/City University of New York (CUNY) sentence tests. Most studies demonstrated measurable postoperative auditory benefit. DHI outcomes were reported in 3 studies and generally indicated low to mild residual dizziness-related handicap. THI outcomes, reported in 3 studies, suggested a low to mild residual tinnitus burden. Surgical complications were reported in 2 studies, while postoperative imbalance or recurrent vertigo was described in selected cohorts.
CONCLUSION: The combination of labyrinthectomy and CI could provide effective vertigo control while enabling meaningful auditory rehabilitation in carefully selected patients with advanced or treatment-refractory MD.