双侧梅尼埃病的压力治疗：一项前瞻性研究。
Pressure Therapy in Bilateral Ménière's Disease: A Prospective Study.
文献信息
| PMID | 42732621 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Edoardo Covelli |
| 作者单位 | Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Medicine and Psychology, Otolaryngology Unit, Sapienza University, Rome, Italy. |
| 期刊 | The journal of international advanced otology |
| SCI 分区 | Q3 |
| IF | 1.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 梅尼埃病（MD）是一种内耳疾病，其特征为不可预测的眩晕发作、耳鸣和耳闷胀感，最终导致前庭听觉功能下降。MD与内淋巴积水（EH）相关，常进展为双侧受累（BMD）。当保守治疗失败时，MD需要破坏性治疗。然而，在双侧病例中，这对于保留听力是一项高风险选择。压力治疗（PT）是一种利用低压脉冲作用于中耳的非侵入性治疗，已显示出减少EH和缓解MD症状的潜力。本研究旨在评估PT治疗BMD的疗效。
方法： 这项前瞻性研究纳入了对标准治疗难治的BMD患者。使用咔嗒声刺激的耳蜗电图（ECochG）来识别活动性MD耳。患者在接受治疗的患侧进行PT治疗24个月。在1、3、6和24个月后，使用ECochG总和电位与动作电位（SP/AP）比值和眩晕障碍量表（DHI）重新评估结果。对侧耳作为对照。
结果： 压力治疗显著降低了活动性MD耳的EH（ECochG SP/AP比值）（P < .001），并改善了DHI评分（P < .001）。对侧未治疗耳未见显著变化（P=.9687）。
结论： 压力治疗可缓解难治性BMD的症状并改善生活质量，在标准保守治疗失败的情况下，为侵入性手术前提供了一种非破坏性的替代选择。
英文摘要
BACKGROUND: Ménière's disease (MD) is an inner ear disorder characterized by unpredictable vertigo attacks, tinnitus, and aural fullness, ultimately leading to a decline in audiovestibular function. Linked to endolymphatic hydrops (EH), MD often progresses to bilateral involvement (BMD). When conservative therapies fail, MD requires destructive treatments. However, this is a high-risk choice in bilateral cases for hearing preservation. Pressure therapy (PT), a non-invasive treatment using low-pressure pulses to the middle ear, has shown potential in reducing EH and alleviating MD symptoms. This study aims to evaluate the efficacy of PT in treating BMD.
METHODS: This prospective study enrolled patients with BMD refractory to standard therapy. Electrocochleography (ECochG) using click stimuli was used to identify the active MD ear. Patients underwent PT for 24 months on the affected side. Outcomes were re-assessed using the ECochG Summating Potential-to-Action Potential (SP/AP) ratio and the Dizziness Handicap Inventory (DHI) after 1, 3, 6, and 24 months. The contralateral ear was used as a control.
RESULTS: Pressure therapy significantly reduced the EH (ECochG SP/AP ratio) in active MD ears (P < .001) and improved DHI scores (P < .001). The contralateral non-treated ear showed no significant changes (P=.9687).
CONCLUSION: Pressure therapy alleviates symptoms and improves quality of life in refractory BMD, offering a non-destructive alternative before invasive procedures in case of standard conservative therapy failure.