经鼓室耳蜗电图（TT-ECochG）的变化是否反映MRI上内淋巴积水的动态变化？前庭神经切断术后重度梅尼埃病患者的听力学与影像学纵向分析——一项初步研究。
Do Changes in Transtympanic Electrocochleography (TT-ECochG) Reflect the Dynamics of Endolymphatic Hydrops on MRI? Audiological and Radiological Longitudinal Analysis in Patients with Severe Ménière's Disease After Vestibular Neurectomy-A Pilot Study.
文献信息
| PMID | 42795936 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Agnieszka Jasinska-Nowacka |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, 02-091 Warsaw, Poland. |
| 期刊 | Journal of clinical medicine |
| SCI 分区 | Q1 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本研究旨在评估梅尼埃病（MD）患者前庭神经切断术后经鼓室耳蜗电图（TT-ECochG）的长期变化，并探讨其与内淋巴积水（EH）程度及听力结局的关系。方法：这项初步研究纳入了5例单侧MD患者，来自20例接受中颅窝前庭神经切断术的患者队列中符合条件者。所有参与者均完成了术前及术后2年的临床和听力学检查，包括TT-ECochG；在延迟钆增强磁共振图像（MRI）上分析EH程度。分析TT-ECochG参数的变化与MRI表现的关系。结果：所有患者均实现了眩晕的完全控制，并且AAO-HNS功能水平改善。2例患者（40%）观察到听力下降≥10 dB。所有患者耳蜗EH保持不变，而2例患者（40%）术后可见前庭EH减轻。2例患者（40%）观察到SP/AP振幅和/或面积比降低，而另外2例（40%）发现数值升高。1例患者因术后重度听力损失未获得术后TT-ECochG反应。总体而言，TT-ECochG参数的变化与MRI表现并不平行。结论：这项初步研究表明，前庭神经切断术后TT-ECochG变化具有异质性，并且与内淋巴积水的MRI变化并不一致平行。
英文摘要
Objectives: The aim of this study was to evaluate long-term changes in transtympanic electrocochleography (TT-ECochG) following vestibular neurectomy in patients with Ménière's disease (MD) and to investigate their relationship with endolymphatic hydrops (EH) degree and hearing outcomes. Methods: This pilot study included five patients with unilateral MD eligible from a cohort of twenty patients who underwent middle fossa vestibular neurectomy. All participants completed preoperative and 2-year postoperative clinical and audiological tests, including TT-ECochG; EH degree was analyzed in delayed gadolinium-enhanced magnetic resonance images (MRI). Changes in TT-ECochG parameters were analyzed in relation to MRI findings. Results: All patients achieved complete control of vertigo and improvement in the AAO-HNS functional level. Hearing deterioration of ≥10 dB was observed in two patients (40%). Cochlear EH remained unchanged in all patients, whereas vestibular EH reduction was visualized in two patients (40%) after surgery. Decreased SP/AP amplitude and/or area ratios were observed in two patients (40%), whereas increased values were found in two others (40%). No postoperative TT-ECochG response was obtained in one patient because of profound postoperative hearing loss. Overall, changes in TT-ECochG parameters did not parallel MRI findings. Conclusions: This pilot study demonstrates that postoperative TT-ECochG changes after vestibular neurectomy are heterogeneous and do not consistently parallel MRI changes in endolymphatic hydrops.