多种围手术期干预提高三联半规管阻塞术治疗难治性梅尼埃病的听力保留率：一项回顾性匹配病例对照研究
Multiple perioperative interventions increase hearing preservation rate in triple semicircular canal occlusion for intractable Menierès disease: a retrospective matched case-control study.
文献信息
| PMID | 42960573 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yupeng Liu |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. |
| 期刊 | Acta oto-laryngologica |
| 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： 三联半规管阻塞术（TSCO）对梅尼埃病（MD）的眩晕控制有效，但术后听力恶化仍是一个关注点。
目的： 确定多模式围手术期听力保护策略是否能减少TSCO后的听力损失。
材料与方法： 在这项回顾性匹配病例对照研究中，28例接受围手术期干预的TSCO患者——包括术中耳蜗电图（ECochG）、低速钻孔、同期半规管开窗、地塞米松冲洗以及术后皮质类固醇联合倍他司汀——与对照组按1:1匹配。术前及术后3个月进行纯音测听。
结果： 干预组显示出显著更小的PTA变化（5.10 ± 9.85 vs. 16.80 ± 15.20 dB HL，p < 0.05）和更高的听力保留率（82.1% vs. 42.9%）。术中ECochG出现波动的患者术后听力恶化更明显（12.40 ± 6.48 vs. 0.52 ± 3.28 dB HL，p < 0.01）。
结论： 多模式围手术期干预显著改善TSCO后的短期听力结局。ECochG监测提供实时功能反馈，并可能降低耳蜗损伤风险。
意义： 这些发现支持标准化的围手术期听力保护方案，并强调ECochG作为提高TSCO治疗难治性MD的安全性和接受度的有价值辅助手段。
英文摘要
BACKGROUND: Triple semicircular canal occlusion (TSCO) is effective for vertigo control in Meniere's disease (MD), yet postoperative hearing deterioration remains a concern.
OBJECTIVES: To determine whether a multimodal perioperative hearing-preservation strategy reduces hearing loss following TSCO.
MATERIAL AND METHODS: In this retrospective matched case-control study, 28 TSCO patients receiving perioperative interventions-including intraoperative electrocochleography (ECochG), low-speed drilling, simultaneous canal fenestration, dexamethasone irrigation, and postoperative corticosteroids with betahistine-were matched 1:1 with controls. Pure-tone audiometry was conducted preoperatively and at 3 months postoperatively.
RESULTS: The intervention group demonstrated significantly smaller PTA change (5.10 ± 9.85 vs. 16.80 ± 15.20 dB HL, p < 0.05) and a higher hearing preservation rate (82.1% vs. 42.9%). Patients with intraoperative ECochG fluctuations experienced greater postoperative hearing deterioration (12.40 ± 6.48 vs. 0.52 ± 3.28 dB HL, p < 0.01).
CONCLUSIONS: Multimodal perioperative interventions significantly improve short-term hearing outcomes after TSCO. ECochG monitoring provides real-time functional feedback and may reduce cochlear injury risk.
SIGNIFICANCE: These findings support standardized perioperative hearing-protection protocols and highlight ECochG as a valuable adjunct to improve the safety and acceptance of TSCO in refractory MD.