迷路后径路前庭神经切断术治疗难治性梅尼埃病75例

Therapeutic effectiveness of 75 cases of retrolabyrinthine vestibular neurectomy for intractable Meniere’s disease

目的探讨迷路后径路前庭神经切断术治疗难治性梅尼埃病的手术安全性、可靠性、术后疗效。方法回顾性分析75例单侧难治性梅尼埃病患者行经迷路后径路前庭神经切断术的临床资料。结果75例患者平均病程(53.11±43.87)个月,术前500 Hz、1000 Hz、2000 Hz、4000 Hz平均听阈(63.71±16.85)dB HL。听力分期Ⅱ期2例,Ⅲ期34例,Ⅳ期39例。Ⅱ期2例患者为内淋巴囊减压术后复发患者。术后颅内感染1例(1.3%)、脑脊液漏4例(5.3%)、暂时性面瘫1例(1.3%)、切口感染2例(2.6%)、切口脂肪液化3例(3.9%)。无颅内出血及术后即刻全聋的病例。术后眩晕疗效评定73例患者为A级,2例患者为B级。结论经迷路后前庭神经切断术疗效确切,风险与并发症可控,可显著改善患者生活质量。

Objective To determine the therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Meniere’s disease.Methods Clinical data of 75 patients with unilateral intractable Meniere’s disease who underwent retrolabyrinthine vestibular neurectomy were retrospectively investigated.Therapeutic effectiveness was analyzed,and the safety and reliability of the procedure was discussed.Results The mean duration of the disease was 53.11±43.87 months.Preoperative pure tone average of 500 Hz,1000 Hz,2000 Hz,and 4000 Hz was(63.71±16.85)dB HL.Two cases were stageⅡ,34 cases were stageⅢ,and 39 cases were stageⅣ.Two stageⅡpatients were recurrent cases after endolymphatic sac decompression surgery.Intracranial infection in 1 case(1.3%),cerebrospinal fluid leakage in 4 cases(5.3%),temporal facial nerve palsy in 1 case(1.3%),incision infection in 2 cases(2.6%),and fat liquefaction in 3 cases(3.9%)were observed postoperatively.There was no case of intracranial hemorrhage or total deafness.Therapeutic effectiveness for relieving vertigo was level A in 73 cases and level B in 2 cases.Conclusion The therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Meniere’s disease is definite.Surgical risk and postoperative complications are controllable,and the quality of life can be significantly improved after surgery.