梅尼埃病的手术疗效分析  

Outcomes of surgical management in meniere’s disease

作　　者：陈颖[1,2] 杨军[1,2] 黄琦[1,2] 汪照炎[1,2] 张治华[1,2] 吴皓[1,2] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉-头颈外科,上海200092 [2]上海交通大学医学院耳科学研究所,上海200233

出　　处：《中华耳科学杂志》2012年第1期52-55,共4页Chinese Journal of Otology

基　　金：卫生部科研专项-我国耳鼻重大疾病的早期发现;规范诊治和防控(编号:201002026);"十一五"国家科技支撑计划-前庭中枢代偿机制及眩晕疾病规范化诊断与康复治疗方案研究(编号:2007BAI18B13)

摘　　要：目的比较前庭神经切断及内淋巴囊手术治疗梅尼埃病效果。方法将所有梅尼埃病患者根据听力及生活质量情况进行分期;根据分期情况予以非手术治疗以及内淋巴囊减压或引流术、前庭神经切断术。分析手术治疗梅尼埃病患者病史特点、手术情况;对于手术满24个月以上的梅尼埃病患者进行术前术后的眩晕、听力及生活质量等疗效评价。结果手术治疗梅尼埃病共77例患者79次手术(1例双侧梅尼埃病患者接受左右各1次内淋巴囊减压术;另1例双侧梅尼埃病患者接受了左侧前庭神经切断术及1次右侧内淋巴囊减压术),其中内淋巴囊手术34次,前庭神经切断术45次。术后24个月的眩晕控制率为:内淋巴囊手术73%,前庭神经切断术100%。结论内淋巴囊减压或引流术可以减轻患者眩晕、改善患者的生活质量;前庭神法。Objective To analyze and compare outcomes of endolymphatic sac surgery and vestibular neurectomy in Meniere＇s disease. Method Patients with Meniere＇s disease were staged according to hearing and quality of life. The individual management according to the staging was established, including outpatient treatments, endolymphatic sac decompression or drainage and vestibular neurectomy. The characteristics of patients who underwent surgical management were analyzed. The functional outcomes of surgery in dizziness, hearing loss and quality of life were evaluated at 24 month postoperative follow-up. Results There were 77 patients who underwent surgical managements for 79 times. One patient with bilateral Meniere＇s disease underwent sac decompression for each side. Another case of bilateral Meniere＇s received vestibular neurectomy on the left and endolymphatic sac decompression on the right side. Endolymphatic sac decompression or drainage was carried out in 33 patients for 34 times, vestibular neurectomy in 45 patients. Control rate of vertigo was 73% in patients with endolymphatic sac decompression or drainage, 100% in vestibular neurectomy at postoperative follow-up of 24 months. Conclusion Endolymphatic sac decompression or drainage could improve vertigo and ameliorate quality of life. Vestibular neurectomy is effective surgical management to eradicate vertigo.

关 键 词：梅尼埃病 前庭神经 内淋巴囊 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]