鼓膜置管鼓室充气治疗难治性梅尼埃病

Clinical Evaluation of Intratympanic Methylprednisolone Perfusion and Tympanum Inflation for Intractable Menier's Disease

目的探讨鼓膜置管灌注甲泼尼龙联合鼓室充气治疗难治性梅尼埃病的疗效。方法回顾性分析2011年8月—2012年8月在邯郸市第三医院住院治疗的12例单侧难治性梅尼病患者,在耳内镜下行鼓膜置管后,鼓室灌注甲泼尼龙联合鼓气耳镜进行鼓室充气治疗,观测患者眩晕、听力及耳鸣变化18-24个月。结果眩晕完全控制2例,基本控制7例,部分控制2例,无明显变化1例。听力0.5、1、2、3KHz气导平均听阈值提高10d BHL2例,提高5 d BHL3例,听力未改善6例,1例听力下降10d BHL。耳鸣消失者4例,明显减轻者6例,无明显变化者2例。结论应用鼓膜置管灌注甲泼尼龙联合鼓室充气治疗难治性梅尼埃病,短期可有效的控制眩晕,明显改善耳鸣,听力改善不明显。对于常规药物治疗无效的MD患者,选择鼓膜置管灌注甲泼尼龙联合鼓气球鼓室充气治疗难治性梅尼埃病是手术操作方便、安全、经济实用的有效治疗方法。

Objective To evaluate the efficacy of intratympanic methylprednisolone perfusion and tympanum inflation in patients with intractable Meniere’s disease（MD）. Methods Twelve cases （12 ears） of intractable MD, treated by the authors from August 2011 to August 2012, were studied retrospectively. After the micro-catheter was placed into the tympanum of the affected ear, methylprednisolone was injected and the tympanum inflated with air. The patients were observed for six months for changes in vertigo, hearing loss and tinnitus. Results Vertigo was completely controlled in 2 patients, mostly controlled in 7 patients, partially controlled in 2 patients, and not controlled in 1 patient. The average Tinnitus Handicap Inventory score of was Hearing improved by 10 dB in 2 patients, improved 5 dB in 3 patients, 0 dB in 6 patients and worsened in 1 patient. Tinni？tus disappeared in 4 patients, softened in 6 patients and showed no change in 2 patients. Conclusion Intratympanic methyl？prednisolone perfusion and tympanum inflation through the micro-catheter is a safe and effective method worth trying for in？tractable Meniere’s disease.