PDF(Pubmed)
Abstract：
OBJECTIVE: The focus on treating patients with Menière\'s Disease (MD) lies on the reduction of vertigo attacks and the preservation of sensory function. Endolympathic hydrops is considered as an epiphenomenon in MD, which can potentially be altered by endolymphatic sac surgery (ESS). Purpose of the study was to investigate the influences on vertigo control through manipulation of the perilymphatic system with or without ESS.
METHODS: Retrospective data analysis of 86 consecutive patients with MD according to current diagnostic criteria after endolymphatic sac surgery alone (ESSalone; n = 45), cochlear implantation (CI) alone (CIalone; n = 12), and ESS with CI (ESS + CI; n = 29), treated at a tertiary referral center.
METHODS: vertigo control, speech perception pre- and postoperatively.
RESULTS: Gender, side, and preoperative treatment were similar in all groups. Age was younger in the ESSalone-group with 56.2 ± 13.0 years (CIalone = 64.2 ± 11.4 years; ESS + CI = 63.1 ± 9.7 years). Definitive MD was present in all the CIalone, in 79.3% of the ESS + CI and in 59.6% of the ESSalone-patients. Likewise, vertigo control rate was 100% in the CIalone, 89.7% in the ESS + CI and 66.0% in the ESSalone-group.
CONCLUSIONS: Vertigo control was improved in all three groups, however, superior in groups treated with CI, potentially contributed by the manipulation of both the endo- and perilymphatic systems. A more systematic characterization of the patients with larger case numbers and documentation of follow up data would be needed to evaluate a clinical effect more properly.
METHODS: Retrospective data analysis of 86 consecutive patients with MD according to current diagnostic criteria after endolymphatic sac surgery alone (ESSalone; n = 45), cochlear implantation (CI) alone (CIalone; n = 12), and ESS with CI (ESS + CI; n = 29), treated at a tertiary referral center.
METHODS: vertigo control, speech perception pre- and postoperatively.
RESULTS: Gender, side, and preoperative treatment were similar in all groups. Age was younger in the ESSalone-group with 56.2 ± 13.0 years (CIalone = 64.2 ± 11.4 years; ESS + CI = 63.1 ± 9.7 years). Definitive MD was present in all the CIalone, in 79.3% of the ESS + CI and in 59.6% of the ESSalone-patients. Likewise, vertigo control rate was 100% in the CIalone, 89.7% in the ESS + CI and 66.0% in the ESSalone-group.
CONCLUSIONS: Vertigo control was improved in all three groups, however, superior in groups treated with CI, potentially contributed by the manipulation of both the endo- and perilymphatic systems. A more systematic characterization of the patients with larger case numbers and documentation of follow up data would be needed to evaluate a clinical effect more properly.
摘要：
目的：治疗梅尼埃病（MD）患者的重点在于减少眩晕发作和保留感觉功能。内交感神经积液被认为是MD的一种附带现象，内淋巴囊手术（ESS）可能会改变。该研究的目的是研究通过在有或没有ESS的情况下操纵外淋巴系统对眩晕控制的影响。
方法：根据目前的诊断标准，对86例单纯内淋巴囊手术后的连续MD患者进行回顾性数据分析（ESSalone；n=45），单独人工耳蜗植入（CI）（CIalone；n=12），和ESS与CI(ESS+CI；n=29)，在三级转诊中心接受治疗。
方法：眩晕控制，术前和术后的言语感知。
结果：性别，侧面,所有组的术前治疗相似。ESSalone组的年龄较小，为56.2±13.0岁（CIalone=64.2±11.4岁；ESSCI=63.1±9.7岁）。明确的MD存在于所有的CI中，79.3%的ESS+CI患者和59.6%的ESSalone患者。同样，仅CI的眩晕控制率为100%，ESS+CI组为89.7%，ESS单独组为66.0%。
结论：三组的眩晕控制均得到改善，然而,在接受CI治疗的组中更优，这可能是由于内淋巴系统和外淋巴系统的操纵所致。需要对病例数较大的患者进行更系统的表征，并记录随访数据，以更正确地评估临床效果。
方法：根据目前的诊断标准，对86例单纯内淋巴囊手术后的连续MD患者进行回顾性数据分析（ESSalone；n=45），单独人工耳蜗植入（CI）（CIalone；n=12），和ESS与CI(ESS+CI；n=29)，在三级转诊中心接受治疗。
方法：眩晕控制，术前和术后的言语感知。
结果：性别，侧面,所有组的术前治疗相似。ESSalone组的年龄较小，为56.2±13.0岁（CIalone=64.2±11.4岁；ESSCI=63.1±9.7岁）。明确的MD存在于所有的CI中，79.3%的ESS+CI患者和59.6%的ESSalone患者。同样，仅CI的眩晕控制率为100%，ESS+CI组为89.7%，ESS单独组为66.0%。
结论：三组的眩晕控制均得到改善，然而,在接受CI治疗的组中更优，这可能是由于内淋巴系统和外淋巴系统的操纵所致。需要对病例数较大的患者进行更系统的表征，并记录随访数据，以更正确地评估临床效果。
