梅尼埃病：内淋巴管内夹闭结扎术

文献信息

中文摘要

目的： 梅尼埃病的特征是反复发作的眩晕和听力损失，部分患者对药物治疗反应不佳。在这种情况下，曾考虑通过手术降低内淋巴囊压力。近年来，有报道称对尽管接受囊减压但仍顽固发作的患者行内淋巴管阻断后取得了成功结果。本研究评估了内淋巴管阻断后的听力功能和头晕严重程度。
方法： 研究纳入21例患者。术前对患者进行纯音测听、头晕障碍量表以及头晕严重程度和频率的视觉模拟量表评估。比较了在全身麻醉下手术的患者术后一年的结果。
结果： 平均年龄为48岁。平均病程为10.9年，平均随访期为23.4个月。术后未检测到听力阈值显著变化。然而，手术使90.4%的患者眩晕得到控制。
结论： 鉴于内淋巴管阻断术能保留听力、对尽管接受内淋巴囊减压仍持续头晕的患者有效，且严重并发症风险低，本研究推荐其作为仅行内淋巴囊减压术的有力替代方案。

英文摘要

AIM: Ménière's disease is characterized by recurrent vertigo attacks and hearing loss, and some patients do not respond well to medical treatment. In such cases, surgical procedures to reduce endolymphatic sac pressure have been considered. In recent years, successful results have been reported after endolymphatic duct blockage in patients with resistant attacks despite sac decompression. This study evaluated hearing function and the severity of dizziness after endolymphatic duct blockage.
METHODS: Twenty-one patients were included in the study. Preoperative pure-tone audiometry, the Dizziness Handicap Inventory, and a visual analog scale for dizziness severity and frequency were administered to the patients. The postoperative one-year results of patients who were operated on under general anesthesia were compared.
RESULTS: The average age was 48. The average disease duration was 10.9 years, and the average follow-up period was 23.4 months. No significant change in hearing thresholds was detected after surgery. However, surgery provided control of vertigo in 90.4% of patients.
CONCLUSION: This study recommends EDB as a strong alternative to only-ESD, given its preservation of hearing, its effectiveness even in patients with persistent dizziness despite ESD, and its low risk of serious complications.