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山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (8): 30-33.doi: 10.6040/j.issn.1671-7554.0.2021.1171

• 临床医学 • 上一篇    下一篇

半规管阻塞术与迷路切除术治疗70例晚期顽固性梅尼埃病的疗效

田超群,吕亚峰,李霄飞,宋永栋,孔利刚,樊兆民,王海波,张道宫   

  1. 山东大学附属山东省耳鼻喉医院眩晕疾病科, 山东 济南 250022
  • 发布日期:2022-07-27
  • 通讯作者: 张道宫. E-mail:zhangdaogong1978@163.com
  • 基金资助:
    国家自然科学基金(82171150);山东省自然科学基金(ZR2020MH17);山东省泰山学者工程资助(ts20130913)

Comparison of the efficacy between semicircular canal plugging and labyrinthectomy for intractable Menieres disease

TIAN Chaoqun1, LYU Yafeng1, LI Xiaofei1, SONG Yongdong1, KONG Ligang1, FAN Zhaomin1, WANG Haibo, ZHANG Daogong   

  1. Department of Vertigo Disease, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250022, Shandong, China
  • Published:2022-07-27

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摘要： 目的 比较半规管阻塞术与迷路切除术治疗晚期顽固性梅尼埃病的远期疗效。 方法 回顾性分析2015年3月至2016年3月接受半规管阻塞术(n=56)和迷路切除术(n=14)治疗的70例晚期顽固性梅尼埃病患者的临床资料,比较半规管阻塞术(半规管阻塞术组)和迷路切除术(迷路切除术组)两种手术方式的治疗效果。 结果 半规管阻塞术组眩晕总控制率为96.4%(54/56),其中A级控晕率为80.4%(45/56)、B级控晕率为16.1%(9/56);迷路切除组眩晕总控制率为100%(14/14),所有患者均为A级控制;两组眩晕控制有效率差异无统计学意义(P>0.05)。半规管阻塞术组听力下降率为28.6%(16/56),迷路切除组听力损失率为100%(14/14),半规管阻塞术组听力损失率低于迷路切除组(P<0.001)。半规管手术组手术前、后颈源性/眼源性前庭肌源性电位(c/oVEMP)的异常率差异无统计学意义(P均>0.05)。迷路切除术组手术前、后颈源性/眼源性前庭肌源性电位的异常率差异有统计学意义(P=0.014;P=0.006)。半规管阻塞术组、迷路切除组的平衡恢复时间分别为(16.5±5.19)d、(25.07±7.87)d,差异有统计学意义(P<0.001)。 结论 半规管阻塞术治疗晚期顽固性梅尼埃病的疗效优于迷路切除术。

关键词: 半规管阻塞术, 迷路切除术, 梅尼埃病, 手术, 眩晕

Abstract: Objective To compare the long-term efficacy of semicircular canal plugging(SCP)versus labyrinthectomy in the treatment of intractable Menieres disease(MD). Methods A total of 70 MD patients with complete medical document who underwent SCP(n=56)and labyrinthectomy(n=14)in our hospital during March 2015 and March 2016 were retrospectively analyzed. The outcomes after two-year follow-up were compared. Results The total rate of vertigo control in the SCP group was 96.4%(54/56), with 45 cases(80.4%)of class A control and 9(16.1%)of class B control, while the total rate of vertigo control in the labyrinthectomy group was 100%(14/14), and all cases had class A control, with no significant difference between the two groups(P>0.05). The rat of hearing loss in the SCP group was 28.6%(16/56), while all cases in the labyrinthectomy group lost their hearing(14/14), and the rate was lower in the SCP group than in the labyrinthectomy group(P<0.001). There were no significant differences in the abnormality rates of cVEMP and oVEMP in the SCP group before and after surgery(P>0.05), while the differences were significant in the labyrinthectomy group(P=0.014; P=0.006). The time of balance recovery was(16.5±5.19 )days in the SCP group and(25.07±7.87)days in the labyrinthectomy group, which was significantly different(P<0.001). Conclusion SCP is more effective than labyrinthectomy in the treatment of intractable advanced MD.

Key words: Semicircular canal plugging, Labyrinthectomy, Ménières disease, Surgery, Vertigo

中图分类号: 

  • R764.33
[1] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J]. Lancet, 2020, 395(10223): 497-506.
[2] De Luca P, Cassandro C, Ralli M, et al. Dietary restriction for the treatment of Menieres disease [J]. Transl Med UniSa, 2020, 22: 5-9. eCollection 2020 May.
[3] Espinosa-Sanchez JM, Lopez-Escamez JA. The pharmacological management of vertigo in Menieres disease [J]. Expert Opin Pharmacother, 2020, 1(14): 1753-1763
[4] Sajjadi H, Paparella MM. Menieres disease [J]. Lancet, 2008, 372(9636): 406-414.
[5] Zhang D, Lv Y, Han Y, et al. Long-term outcomes of triple semicircular canal plugging for the treatment of intractable Menieres disease: a single center experience of 361 cases [J]. J Vestib Res, 2019, 29(6): 315-322.
[6] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科学分会. 梅尼埃病的诊断依据和疗效评估(2006年,贵阳)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(3): 163-172.
[7] Zhang D, Fan Z, Han Y, et al. Triple semicircular canal plugging: a novel modality for the treatment of intractable Menieres disease [J]. Acta Otolaryngol, 2016, 136(12): 1230-1235.
[8] Zhang D, Fan Z, Han Y, et al. Long-term efficacy of triple semicircular canal occlusion in the treatment of intractable Menieres disease [J]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2015, 50(9): 733-737.
[9] Sood AJ, Lambert PR, Nguyen SA, et al. Endolymphatic sac surgery for Menieres disease: a systematic review and meta-analysis [J]. Otol Neurotol, 2014, 35(6): 1033-1045.
[10] Cooper MW, Kaylie DM. Is Endolymphatic sac surgery beneficial for Menieres disease [J]. Laryngoscope, 2020, 130(12): 2738-2739.
[11] Pang B, Costeloe A, Jackson NM, et al. Incidence of developing contralateral Menieres disease in patients undergoing transmastoid labyrinthectomy for unilateral Menieres disease [J]. Ear Nose Throat J, 2021, 100(2): 86-89.
[12] Bergmark RW, Semco RS, Abdul-Aziz D, et al. Transmatoid labyrinthectomy for Menières disease: experience and outcomes [J]. Otol Neurotol, 2020, 41(10): 1413-1418.
[13] Scarpa A, Ralli M, De Bonis E, et al. Pharmacological, surgical and diagnostic innovations in Menieres disease: a review [J]. Transl Med UniSa, 2020, 1(23): 48-52.
[14] Kitahara T. Evidence of surgical treatments for intractable Menieres disease [J]. Auris Nasus Larynx, 2018, 45(3): 393-398.
[15] Deveze A, Montava M, Lopez C, et al. Vestibular compensation following vestibular neurotomy [J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2015, 132(4): 197-203.
[16] Lyu Y, Zhang D, Li X, et al. Dexamethasone protects the hearing of Menieres disease patients after triple semicircular canal plugging [J]. Acta Otolaryngol, 2020, 140(10): 803-807.
[17] Li X, Lv Y, Wang R, et al. Intraoperative auditory brainstem response monitoring during semicircular canal plugging surgery in treatment of Menieres disease [J]. Acta Otolaryngol, 2021, 141(1): 73-77.
[18] Lee HJ, Lee JM, Shim DB, et al. Is early progression to bilateral involvement in Menieres disease a poor prognostic indicator? [J]. Otol Neurotol, 2019, 40(10): 1333-1338.
[19] Zhang D, Lv Y, Han Y, et al. Revision surgery after triple semicircular canal plugging and morphologic changes of vestibular organ [J]. Sci Rep, 2019, 9(1): 19397. doi: 10.1038/s41598-019-55810-7.
[20] Yu Z, Mcintosh JM, Sadeghi SG, et al. Efferent synaptic transmission at the vestibular type II hair cell synapse [J]. J Neurophysiol, 2020, 124(2): 360-374.
[21] Wijesinghe R, Camp A. The intrinsic plasticity of medial vestibular nucleus neurons during vestibular compensation-a systematic review and meta-analysis [J]. Syst Rev, 2020, 9(1):145. doi: 10.1186/s13643-020-01399-2.
[22] Mao DH, He ZM, Xuan W, et al. Effect and mechanism of BDNF/TrkB signaling on vestibular compensation [J]. Bioengineered. 2021, 12(2): 11823-11836.
[23] Dutia MB. Mechanisms of vestibular compensation: recent advances [J]. Curr Opin Otolaryngol Head Neck Surg, 2010, 18(5): 420-424.
[24] Fukuda J, Matsuda K, Sato G, et al. Effects of betahistine on the development of vestibular compensation after unilateral labyrinthectomy in rats [J]. Brain Sci, 2021, 11(3): 360. doi: 10.3390/brainsci11030360.
[25] Smith PF. Why the cerebellar shutdown/clampdown hypothesis of vestibular compensation is inconsistent with neurophysiological evidence [J]. J Vestib Res, 2020, 30(5): 295-303.
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