半规管阻塞联合内淋巴囊减压术治疗顽固性梅尼埃病的疗效分析

Efficacy of Semicircular Canal Plugging Combined with Endolymphatic Sac Decompression in the Treatment of Intractable Meniere's Disease

目的观察顽固性梅尼埃病患者经半规管阻塞联合内淋巴囊减压术治疗后的临床疗效,为选择治疗该病的有效方法提供帮助。方法回顾性分析我科28例行半规管阻塞联合内淋巴囊减压术的顽固性梅尼埃病患者的临床资料,评估术后患者眩晕控制情况、听力影响情况及耳鸣情况。结果术后眩晕控制情况达A级者25例,B级3例,眩晕障碍量表(Dizziness Handicap Inventory,DHI)评分较术前明显降低(t=54.951,P<0.001);术后纯音平均听阈(Pure Tone Average,PTA)无变化19例,下降9例,与术前相比差异有统计学意义(z=-4.630,P<0.001);耳鸣较术前改善,耳鸣残障量表(Tinnitus Handicap Inventory,THI)评分较术前明显降低(t=2.574,P=0.016)。结论半规管阻塞联合内淋巴囊减压术可有效控制顽固性梅尼埃病的眩晕、缓解耳鸣,是治疗顽固性梅尼埃病的有效方法,但对患者的听力仍有一定的损害风险。

Objective To report treatment outcomes of semicircular canal plugging combined with endolymphatic sac decompression in patients with intractable Meniere's disease.Methods Clinical data of 28 patients with intractable Meniere's disease who underwent semicircular canal plugging combined with endolymphatic sac decompression were included in our study.Vertigo,hearing and tinnitus were evaluated after operation.Results Vertigo control was rated as grade A in 25 cases and grade B in 3 cases,with DHI significantly lower than before operation(t=54.951,P<0.001).PTA remained unchanged in 19 cases and decreased in 9 cases(z=-4.630,P<0.001).Tinnitus improved with THI significantly lower than before operation(t=2.574,P=0.016).Conclusion Semicircular canal plugging combined with endolymphatic sac decompression is an effective treatment for intractable Meniere's disease,although with a certain risk of hearing damage.