内淋巴囊引流术治疗梅尼埃病的远期疗效

Long-term results of endolymphatic sac drainage for Meniere disease

目的评估内淋巴囊引流术治疗梅尼埃病的远期疗效。方法选择1987年3月至2004年9月住院的接受内淋巴囊引流术治疗的梅尼埃病患者共26例,对随访2年以上、资料完整的18例进行了回顾性总结。其诊断和疗效评价均依据1996年中华医学会耳鼻咽喉科学分会和中华耳鼻咽喉科杂志编辑委员会制订的梅尼埃病诊断依据和疗效分级标准。结果 18例患者随访2～13年,其中2～5年2例,≥5年16例;平均9.28年。18例患者术后眩晕 A 级(完全控制)9例(50%),B 级(大部分控制)8例(44.4%),D 级(加重)1例(5.6%);耳鸣消失2例(11.1%),减轻9例(50%),无效7例(38.9%);耳闷胀感消失10例(55.6%),无效8例(44.4%);听力提高(A+B级)6例(33.3%),无明显变化(C 级)4例(22.2%),下降(D 级)8例(44.5%)。手术后均无面神经麻痹、脑脊液瘘、出血、切口感染等并发症。结论内淋巴囊引流手术是治疗梅尼埃病安全有效的方法,大部分病例术后听力得以保存。

Objective To investigate the efficacy of endolymphatic sac drainage for Meniere disease. Methods The efficacy of endolymphatic sac drainage for Meniere disease was retrospectively summed up in 26 patients in General Hospital of Chinese People＇s Liberation Army from March 1987 to September 2004. Of 26 patients, there were eighteen patients followed up more than two years after surgery. Results According to Chinese Meniere disease＇s diagnosis and curative effect standard evaluation criteria published in 1996, for vertigo symptom of these 18 patients, there were 9 cases （ 50% ） with grade A （ completely controlled）,8 cases （44.4%） with grade B （ fundamentally controlled） and one case （ 5.6% ） with grade D （not controlled）. The vertigo fully controlled rate was only 50%, but the vertigo completely or fundamentally controlled rate reached 94. 4%. Tinnitus of the patients after operation disappeared in 2 cases （11.1%） , reduced in 9 case（50% ） and unchanged in 7 cases （ 38. 9% ）. Hearing post operation was improved in 6 cases （ 33. 3% ）, unchanged obviously in 4 cases （ 22. 2% ） and decreased in 8 cases （44. 5% ）. Conclusions Endolymphatic sac drainage was an effective and safe management as well as with less complication for intractable Meniere＇s disease patients with residual hearing before operation.