Endolymphatic sac-vein decompression for intractable Meniere's disease: Long term treatment results
Endolymphatic sac-vein decompression for intractable Meniere's disease: Long term treatment results
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DOI：
10.1016/s0194-5998(03)00084-6
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发表时间：
2003-04-01
影响因子：
3.4
通讯作者：
Kartush, JM
中科院分区：
文献类型：
--
作者：
Ostrowski, VB;Kartush, JM
目的：我们试图确定内淋巴囊静脉减压手术对经典梅尼埃病患者的长期疗效。 研究设计和背景：使用 1995 年美国耳鼻喉科学会-头颈外科委员会听力和平衡标准，对起始阶段、功能水平、眩晕等级和听力结果进行了讨论。我们研究了来自三级私人耳科神经科诊所的 68 名典型梅尼埃病患者。通过回顾性图表审查、问卷调查和患者访谈收集患者数据。所有患者均接受内淋巴囊静脉减压术，平均随访55个月。结果：术前中位功能水平为4级，术后改善至2级。 81% 的患者功能水平有所改善，12% 保持稳定，7% 下降。 A 级的长期眩晕控制率为 47%，B 级为 25%，C 级为 9%，D 级为 3%，F 级为 16%。 20% 的患者处于听力 I 期梅尼埃病； 31%，第二阶段； 44%，III期； 5%，第四阶段。 18% 的患者听力等级有所改善，64% 保持稳定，18% 下降。结论：内淋巴囊静脉减压手术是治疗梅尼埃病的一种安全、无损的手术选择，可为大多数有症状的患者提供持久的眩晕控制和听力稳定。意义：内淋巴囊静脉减压手术的长期有益结果支持其继续作为一线治疗方法顽固性梅尼埃病的治疗选择。
OBJECTIVES: We sought to determine the long-term efficacy of endolymphatic sac-vein decompression surgery on patients with classic Meniere's disease.STUDY DESIGN AND SETTING: Using the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium criteria, starting stage, functional level, vertigo class, and hearing results were addressed. We studied 68 patients with classic Meniere's disease from a tertiary, private otology-neurotology practice. Patient data were gathered by retrospective chart review, questionnaire, and patient interview. All patients underwent endolymphatic sac-vein decompression with an average follow-up period of 55 months.RESULTS: Median functional level before surgery was level 4, improving to level 2 after surgery. Eighty-one percent of patients showed improvement in functional level, 12% remained stable, and 7% declined. Long-term vertigo control was 47% in class A, 25% in class B, 9% in class C, 3% in class D, and 16% in class F. Twenty percent of patients were in hearing stage I Meniere's disease; 31%, stage II; 44%, stage III; and 5%, stage IV. Eighteen percent of patients showed improvement in hearing class, 64% were stable, and 18% declined.CONCLUSION: Endolymphatic sac-vein decompression surgery is a safe, nondestructive surgical option for Meniere's disease that offers durable control of vertigo and stabilization of hearing for the majority of symptomatic patients.SIGNIFICANCE: The beneficial long-term outcome of the andolymphafic sac-vein decompression supports its continued use as a first-line treatment option in intractable Meniere's disease.