内淋巴囊减压联合三个半规管填塞术对难治性梅尼埃病的眩晕疗效分析

doi:10.3969/j.issn.1006-7795.2022.04.005

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 540-545.doi: 10.3969/j.issn.1006-7795.2022.04.005

• 耳聋疾病:基础研究到临床诊疗 • 上一篇下一篇

内淋巴囊减压联合三个半规管填塞术对难治性梅尼埃病的眩晕疗效分析

冯蓉^1,2,3, 刘韵^1,2, 王国鹏^1,2, 龚树生^1,2*

1.首都医科大学附属北京友谊医院耳鼻咽喉头颈外科,北京 100050;
2.首都医科大学耳聋疾病临床诊疗与研究中心,北京 100050;
3.延安市人民医院耳鼻咽喉头颈外科,陕西延安 716000

收稿日期:2022-04-29 出版日期:2022-08-21 发布日期:2022-10-28
基金资助:
北京市自然科学基金(7212022)。

Analysis of the efficacy of endolymphatic sac decompression combined with triple semicircular canal plugging for vertigo in refractory Meniere's disease

Feng Rong ^1,2,3, Liu Yun ^1,2, Wang Guopeng^1,2, Gong Shusheng^1,2*

1. Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
2. Clinical Center for Hearing Loss, Capital Medical University, Beijing 100050, China;
3. Department of Otorhinolaryngology-Head and Neck Surgery, Yan'an City People's Hospital, Yan'an 716000, Shaanxi Province, China

Received:2022-04-29 Online:2022-08-21 Published:2022-10-28
Contact: *E-mail:gongss@ccmu.edu.cn
Supported by:
This study was supported by Natural Science Foundation of Beijing (7212022).

摘要/Abstract

摘要： 目的探讨内淋巴囊减压联合三个半规管填塞术治疗难治性梅尼埃病眩晕症状的疗效,术后对平衡能力及生活质量的影响。方法选择26例难治性梅尼埃病患者,完成内淋巴囊减压联合三个半规管填塞术,记录患者手术前后眩晕控制情况、平衡能力、听力情况、眩晕残障程度(Dizziness Handicap Inventory,DHI)评分、耳鸣障碍量表(Tinnitus Handicap Inventory,THI)评分和耳鸣痛苦程度分级,分析手术效果。结果 26例患者术后眩晕明显改善,眩晕完全控制率为88.46%,有效率为100%。术后出现平衡不稳感,平均(5.08±4.52)个月好转,均无跌倒风险。术后眼震发生率69.23%,平均(5.00±2.67)d症状消失。通过Burg评分和视觉模拟量表评分发现,随着术后时间延长,患者平衡能力逐渐恢复,DHI评分表明随术后时间延长,患者生活质量逐渐好转,在术后6个月时趋于稳定。此外,与术前相比,26例患者术后6个月的平均听力阈值略有升高,但差异无统计学意义;术后6个月的耳鸣THI量表评分和耳鸣痛苦程度分级均下降。结论内淋巴囊减压联合三个半规管填塞术对眩晕控制效果好,患者术后生活质量明显提高,受影响的主观平衡能力约5个月后恢复正常。

关键词: 梅尼埃病, 半规管阻塞, 内淋巴囊减压, 眩晕

Abstract: Objective To investigate the efficacy of endolymphatic sac decompression combined with triple semicircular canal plugging for the treatment of vertigo symptoms in refractory Meniere's disease and the postoperative effects on balance function and quality of life. Methods Twenty-six patients with refractory Meniere's disease were enrolled to undergo endolymphatic sac decompression combined with triple semicircular canal plugging. The pre-and post-operative vertigo control, balance, hearing, Dizziness Handicap Inventory(DHI),Tinnitus Handicap Inventory(THI) and tinnitus pain level of patients were analyzed. Results The vertigo improved significantly in 26 patients after surgery, and the rate of complete control of vertigo was 88.46%, with an effective rate of 100%. The postoperative sensation of balance instability was improved in an average of (5.08±4.52) months, and all of them had no risk of falling. The incidence of postoperative nystagmus was 69.23%, and the symptoms disappeared in about (5.00±2.67) days. The Burg score and visual analogue scale score revealed that the patients' balance gradually recovered as the postoperative time was prolonged. The DHI score indicated that the patients' quality of life gradually improved as the postoperative time was prolonged and stabilized at 6 months after surgery. In addition, the mean hearing threshold was slightly higher in 26 patients at 6 months postoperatively compared with that preoperatively, but not statistically significant. THI scores and tinnitus pain level were decreased at 6 months postoperatively. Conclusion This study showed good control of vertigo with endolymphatic sac decompression combined with triple semicircular canal plugging, significant improvement in postoperative quality of life, and some effect on subjective balance, which returned to normal after about 5 months.

Key words: Meniere's disease, semicircular canal obstruction, endolymphatic sac decompression, vertigo

中图分类号:

冯蓉, 刘韵, 王国鹏, 龚树生. 内淋巴囊减压联合三个半规管填塞术对难治性梅尼埃病的眩晕疗效分析[J]. 首都医科大学学报, 2022, 43(4): 540-545.

Feng Rong, Liu Yun, Wang Guopeng, Gong Shusheng. Analysis of the efficacy of endolymphatic sac decompression combined with triple semicircular canal plugging for vertigo in refractory Meniere's disease[J]. Journal of Capital Medical University, 2022, 43(4): 540-545.

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内淋巴囊减压联合三个半规管填塞术对难治性梅尼埃病的眩晕疗效分析

Analysis of the efficacy of endolymphatic sac decompression combined with triple semicircular canal plugging for vertigo in refractory Meniere's disease

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