外后半规管阻塞伴内淋巴囊减压治疗顽固性梅尼埃病外科技术探讨  

The surgical treatment discussion in intractable Meniere's disease:lateral and posterior semicircular canal plugging with endolymphatic sac decompression

作　　者：杨凤[1] 宋任东[1] 刘伟[1] 张海东[1] 刘阳[2] 

机构地区：[1]保定市第二中心医院耳鼻咽喉科,河北涿州072750 [2]海军总医院耳鼻咽喉头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第2期127-129,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：河北省医学科学研究重点课题计划(No:20150009)

摘　　要：目的:探讨在内淋巴囊减压的基础上同时行外、后半规管阻塞治疗顽固性梅尼埃病的外科技术。方法:选择33例中晚期梅尼埃病患者,均在全身麻醉下完成内淋巴减压,同时磨开外、后半规管骨质,以软组织填塞外后半规管管腔。结果:所有患者均顺利完成手术,术后无面瘫、全聋及新生耳鸣发生;所有患者均有头朦胧感、不平衡感,其中术后1周内6例语言频率骨导听力下降,1例术后2个月发生突发性听力下降伴旋转性眩晕直至全聋。结论:该研究设计的理论基于减轻内淋巴积水压力与对传导通路的控制,在切除内淋巴囊表面骨质的基础上同时行外、后半规管阻塞,外科技术较易掌握。Objective：To introduce and discuss a surgical technique,i.e.lateral ＆posterior semicircular canal plugging with endolymphatic sac decompression,to treat intractable Meniere’s disease.Method：Thirty-three cases of intractable Meniere’s disease were enrolled.All cases were performed under general anesthesia.The endolymphatic sac was decompressed and the bone of lateral ＆posterior canal were drilled to create a fenestra followed by soft tissue plugging into the canal.Result：All cases had no facial palsy,no total defness,no vertical after surgery.In the period of following up,the attack of Meniere’s disease was completely controlled and the hearing loss happened for 6case one week after operation.One case had sudden hearing loss with vertical and result of defness.Conclusion：The design of this surgical procedure was based on relieving endolymphatic press and controlling the nerve pulse transmission.The surgical technique was reliable for lateral ＆ posterior semicircular canal plugging with endolymphatic sac decompression.

关 键 词：梅尼埃病 半规管阻塞 内淋巴囊减压 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]