Ménière's disease(MD) is a common cause of recurrent vertigo. Its pathophysiology is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients ...Ménière's disease(MD) is a common cause of recurrent vertigo. Its pathophysiology is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops(EH). However, not all cases of hydrops are associated with MD and it may represent the end point of various etiologies. The diagnostic criteria for MD have undergone changes during the past few decades. A recent collaboration among specialty societies in United States, Europe and Japan has given rise to a new set of guidelines for the diagnosis and classification of MD. The aim is to develop international consensus criteria for MD that would help improve the quality of data collected from patients. The diagnosis of MD can be difficult in some cases as there is no gold standard for testing. Previous use of audiometric data and electrocochleography are poorly sensitive as screening tools. Recently magnetic resonance imaging as a diagnostic tool for identifying EH has gained popularity in Asia and Europe. Vestibular evoked myogenic potentials are also used but lack specificity. Finally, the treatment for MD has improved with the introduction of intratympanic treatments with steroids and gentamicin as well as less invasive treatment with the Meniett device.展开更多
Background: The aim of this study was to identify the prevalence of tinnitus in a sample of people with early stages of Ménière’s disease. Material and methods: A postal survey was sent to 256 patients all ...Background: The aim of this study was to identify the prevalence of tinnitus in a sample of people with early stages of Ménière’s disease. Material and methods: A postal survey was sent to 256 patients all judged to fulfil the criteria of early unilateral Ménière’s disease established by the American Academy of Otolaryngology Committee on Hearing and Equilibrium. Of these 256 patients, 136 had probable Ménière’s disease and 120 had early possible Ménière’s disease. The same questionnaire was mailed and administered to 60 control subjects with no history of vestibular dysfunction. A total of 158 subjects completed the questionnaire. Results: Tinnitus was found in 54 (63%) of the 72 members of the final unilateral vestibular Ménière’s disease group and 61 (85 %) of the 72 members of the final unilateral probable Ménière’s disease group. Conclusion: The prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with probable Ménière’s disease than in patients with early vestibular Ménière’s disease or in control subjects. However, the prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with early vestibular Ménière’s disease than in control subjects.展开更多
BACKGROUND Although long-term retention of a ventilation tube is required in many ear diseases,spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo.To address this issue,we ai...BACKGROUND Although long-term retention of a ventilation tube is required in many ear diseases,spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo.To address this issue,we aimed to determine a new method for long-term retention of the ventilation tube.AIM To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes.METHODS A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm(via surgical exfoliation)in patients who underwent myringotomy with ventilation tube placement.The patients were randomly divided into two groups:Control group and treatment group.Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic,whereas those in the control group did not have their biofilm removed.Only conventional ventilation tubes were placed in this study.Outcome measures were tube position and patency.Tube retention time and any complications were documented.RESULTS Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study.The tympanostomy tube retention time was significantly longer in the treatment group(43.5±26.4 mo)than in the control group(9.5±6.9 mo)(P=0.003).More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group(P=0.01).CONCLUSION Despite the use of short-term ventilation tubes,direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.展开更多
文摘Ménière's disease(MD) is a common cause of recurrent vertigo. Its pathophysiology is still unclear and controversial. The most common histological finding in postmortem temporal bone studies of patients is endolymphatic hydrops(EH). However, not all cases of hydrops are associated with MD and it may represent the end point of various etiologies. The diagnostic criteria for MD have undergone changes during the past few decades. A recent collaboration among specialty societies in United States, Europe and Japan has given rise to a new set of guidelines for the diagnosis and classification of MD. The aim is to develop international consensus criteria for MD that would help improve the quality of data collected from patients. The diagnosis of MD can be difficult in some cases as there is no gold standard for testing. Previous use of audiometric data and electrocochleography are poorly sensitive as screening tools. Recently magnetic resonance imaging as a diagnostic tool for identifying EH has gained popularity in Asia and Europe. Vestibular evoked myogenic potentials are also used but lack specificity. Finally, the treatment for MD has improved with the introduction of intratympanic treatments with steroids and gentamicin as well as less invasive treatment with the Meniett device.
文摘Background: The aim of this study was to identify the prevalence of tinnitus in a sample of people with early stages of Ménière’s disease. Material and methods: A postal survey was sent to 256 patients all judged to fulfil the criteria of early unilateral Ménière’s disease established by the American Academy of Otolaryngology Committee on Hearing and Equilibrium. Of these 256 patients, 136 had probable Ménière’s disease and 120 had early possible Ménière’s disease. The same questionnaire was mailed and administered to 60 control subjects with no history of vestibular dysfunction. A total of 158 subjects completed the questionnaire. Results: Tinnitus was found in 54 (63%) of the 72 members of the final unilateral vestibular Ménière’s disease group and 61 (85 %) of the 72 members of the final unilateral probable Ménière’s disease group. Conclusion: The prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with probable Ménière’s disease than in patients with early vestibular Ménière’s disease or in control subjects. However, the prevalence of tinnitus as determined by a questionnaire survey was significantly greater in patients with early vestibular Ménière’s disease than in control subjects.
基金Supported by Shanghai Leadership Talent Training Plan,No. 2017062the Key Project of Shanghai Jiao Tong University Medicine Science and Engineering Interdisciplinary Foundation,No. YG2016ZD02+3 种基金Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support,No.20152233Multi-Center Clinical Research Plan of Medical College of Shanghai Jiao Tong University,No. DLY201823the Clinical Research Plan of Shanghai Shen Kang Hospital Development Center,No. 16CR4022A and No.16CR3041ANational Natural Science Foundation of China,No.81974142.
文摘BACKGROUND Although long-term retention of a ventilation tube is required in many ear diseases,spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo.To address this issue,we aimed to determine a new method for long-term retention of the ventilation tube.AIM To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes.METHODS A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm(via surgical exfoliation)in patients who underwent myringotomy with ventilation tube placement.The patients were randomly divided into two groups:Control group and treatment group.Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic,whereas those in the control group did not have their biofilm removed.Only conventional ventilation tubes were placed in this study.Outcome measures were tube position and patency.Tube retention time and any complications were documented.RESULTS Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study.The tympanostomy tube retention time was significantly longer in the treatment group(43.5±26.4 mo)than in the control group(9.5±6.9 mo)(P=0.003).More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group(P=0.01).CONCLUSION Despite the use of short-term ventilation tubes,direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.
