单侧梅尼埃病患者双侧耳蜗电图检查的意义

Clinical Application of Bilateral Electrocochleogram in Diagnosing Meniere Disease

目的分析梅尼埃病患者双侧耳蜗电图，以早期发现一侧梅尼埃病对侧耳膜迷路积水的可能性。了解梅尼埃病患者对侧无症状耳内淋巴积水可能的发生率。方法对明确诊断为梅尼埃病的121例患者行双侧耳蜗电图检查，对其中可统计出明确病程的114例比较其双侧耳蜗电图结果与病程的关系。结果可以统计出梅尼埃病病程的114例中，单侧异常46例，平均病程7．42±7．68年（5天-37年）；双侧异常38例，平均病程5．43±5．73年（3个月-20年）；双侧正常者30例，平均病程5．37±4．40年（4个月-12年）。三种情况下，病程与耳蜗电图结果无直线相关（P〉0．05）。在121例行双侧耳蜗电图检查的病例中，双侧耳蜗电图异常者39例。其中9例有双侧耳鸣，占23．1％（9／39），而单侧耳蜗电图异常者51例中，出现双侧耳鸣的仅有1例，占2％（1／51），双侧耳蜗电图异常伴双侧耳鸣的发生率明显高于单侧耳蜗电图异常伴双侧耳鸣的发生率（P〈0．01）。结论耳蜗电图对梅尼埃病诊断的评价应建立在对梅尼埃病动态变化的理解基础之上；耳蜗电图对早期听力正常的梅尼埃病的诊断具有一定的参考价值。

Objective To use bilateral eleetrocochleogram（ECoG） identification of for early patients with Meniere disease who demonstrated contralateral endolymphatic hydrops without symptoms. Methods The patients with Meniere disease were tested with bilateral electroeochleogram. The relation ship between duration of Meniere disesase and the results of ECoG was studied. Resuits 114 patients with Meniere disesase underwent bilateral ECoG. 51 had abnormal results at one side and the average duration were 7.42 ± 7.68 years （5 days - 7 years）; 38 were abnormal bilaterally and the average duration were 5.43 ± 5.73 years（ 3 months - 20 years） ; 30 had normal ECoG bilaterally with the average duration of 5.37 ± 4.40 years （4 months- 12 years）. No statistically significant correlation was found between the abnormality of ECoG and the average duration of Meniere disease（ P 〉 0. 05）. Furthermore, there were 9 patients with beth bilateral abnormal ECoG and bilateral tinnitus. The percentage of bilateral abnormal ECoG with tinnitus was 23.1% （9/39）. In comparison, there was only 2 % （ 1/51） patient suffering tinnitus on the contralateral ear with abnormal ECoG on one side. The positive rate of bilateral abnormal with bilateral tinnitus was higher than that of the abnormal ECoG on one side with eontralateral tinnitus （ P 〈 0.01）. Conclusion Bilateral ECoG may play an role in the early diagnosis of Meniere disease in view of the fact that it may serve as an predictive factor for the possibility of endolymphatic hydrops in the asymptomatie ear.