鼓室内注入法治疗顽固性梅尼埃病的疗效观察

Therapeutic efficiency of intratympanic gentamycin for infractable meniere′s disease

目的 :观察鼓室内注入庆大霉素治疗顽固性梅尼埃病 ( Meniere病 )远期疗效。方法 :对 40例患者 ( 4 5耳次 )的症状、检查结果、术后随诊 2 a～ 10 a的疗效进行调查及分析。结果 :典型三症同时出现者 2 0例 ,以眩晕为首发症状者 12例 ,耳聋 8例。听功能检查 :纯音测听中、重度受损者 3 4例占 85 % ,Ecoch G— SP/AP≥ 0 .3 7者占 77.5 % ,甘油试验阳性者 72 .5 % ;患侧半规管功能低下者占 87.5 %。结果 :眩晕完全控制 3 2耳 ( 71.1% ) ,次完全控制 9耳 ( 2 0 .0% )。听力好转者 0耳次 ,不变 3 0耳次 ,恶化者 15耳次。结论 :手术治疗控制眩晕有效率为 91.1% 。

Objective:To evaluated the effect of tympanotomy in jection to cure stubborn Meniere′s disease.Methods:The complains,results of exa mination and their effects were investigated for the 40 cases(45 ears) tith retr o-specrive analyses.Results:The 50% out of patients initial symptoms starded w ith typical Meniere striad,the initial symptoms starded wity vertigo attacks we re 12 cases,hearing loss combined with tinnitus were 8 cases.The audi-tory func tions showed that:over moderately severe hearing impairment were 34 cases(85.0 %),EcochG-SP/AP≥0.37 were 77.5%,72% glyceoltest evidenced postive reaction .The canal paresis were 87.5% in caloric test.The contral verti-go and auditory senstitivety were separately calculated,the follow-up time were 2～10 years af ter treatment.The complete control of vertigo were 32ears(71.1%).Limited contro l were 20.0%.The hearing improvement were 0 ears,another hearing unchanged wer e 15ears,and worse were 30 ears.Conclusion:The effective rate of vertiginous c ontrol were 91.1% in the tympanotomy injection of stubborn Meniere disease.