迟发性膜迷路积水的诊断与治疗  

Diagnosis and Treatment of Delayed Endolymphatic Hydrops

作　　者：陈曦[1] 罗高青[1] 林少莲[1] 张榕[1] 吴子明[2] 

机构地区：[1]福建医科大学附属第一医院耳鼻咽喉头颈外科,福州350005 [2]解放军总医院耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2010年第1期23-25,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨迟发性膜迷路积水的诊断和治疗。方法回顾性分析37例(40耳)迟发性膜迷路积水患者的临床资料,包括纯音测听、前庭诱发的肌源性电位(vestibular evoked myogenic potentials,VEMP)、高刺激ABR、前庭双温试验等结果。主要予以利尿剂、血管扩张剂等药物治疗。结果37例患者均为中、重度以上感音神经性聋。膜迷路积水与听力下降同侧25例,对侧9例,双侧3例。水平半规管和球囊均有积水10例,水平半规管积水9例,球囊积水15例,VEMP和双温试验均正常3例。VEMP正常12例,异常者25例,其中6例患侧p13-n23振幅消失,5例p13潜伏期延长,14例患侧p13-n23低振幅。37例患者中一周内完全控制眩晕发作18例;眩晕明显减轻、二周后完全控制17例;2例行化学迷路切除后眩晕未再发作。结论迟发性膜迷路积水的诊断应依据纯音测听、耳蜗电图、前庭双温试验和前庭诱发肌源性电位等检查结果综合判定;治疗以药物治疗为主,利尿剂和血管扩张剂是主要治疗药物。Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops（DEH）. Methods A restrospective study was conducted in 37 cases of DEH ,who were tested with pure tone threshold ,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular fuction test. Conservative drug therapy was the major treatment. Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least. Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type. Ten cases had abnormal horizontal semicircular canal （HSCC） hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function. Fifteen cases had abnormal saccular function and normal HSCC function. Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week ,17 cases improved until totally relieved in two weeks ,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack. Conclusion Pure tone threshold ,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops. Consevative drug therapy ,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.

关 键 词：迟发性膜迷路积水 诊断 治疗 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]