Hearing results following intratympanic gentamicin perfusion for Meniere's disease
Hearing results following intratympanic gentamicin perfusion for Meniere's disease
复制标题
DOI：
10.1017/s0022215108003150
复制
发表时间：
2009-04-01
影响因子：
1.7
通讯作者：
Sismanis, A.
中科院分区：
文献类型：
--
作者：
Kyrodimos, E.;Aidonis, I.;Sismanis, A.
目的：评价庆大霉素鼓室内灌注治疗梅尼埃病的听力效果。材料与方法：对经其他治疗无效的梅尼埃病患者行庆大霉素40 mg/ml溶液0.4ml中耳灌注。结果：1999年5月至2005年11月，22例患者接受庆大霉素鼓室内灌注治疗，平均年龄58.5岁。平均随访30个月。在首次灌流后(灌流后4~6周)，22例患者中有3例(13.63%)纯音平均改善至少10分贝，15例(68.18%)无变化，4例(18.18%)听力下降超过10分贝。在言语辨别分数方面，1名患者(4.54%)表现出至少15%的改善，1.5名(68.18%)没有变化，6名(27.27%)表现出至少15%的下降。经长期随访(灌流后12~40个月)，10例(45.45%)听力稳定，12例(54.54%)纯音平均下降10分贝以上。6名患者(27.27%)的言语辨别分数至少下降了15%，而16名患者(72.72%)没有变化。22例患者中有20例(90.9%)眩晕完全消失，2例(9.09%)出现阵发性眩晕。结论：庆大霉素鼓室内灌注可有效控制梅尼埃病患者的眩晕。然而，灌流后可能会立即发生严重的听力损失；因此，应该只考虑对听力已经受到疾病影响的患者进行这种治疗。
Objective: To evaluate hearing results following intratympanic gentamicin perfusion in patients with Meniere's disease.Materials and methods: Middle-ear perfusion of 0.4 ml of gentamicin 40 mg/ml solution was performed in Meniere's disease patients who had previously failed to respond to other medical treatment.Results: Between May 1999 and November 2005, 22 patients (mean age 58.5 years) underwent intratympanic gentamicin perfusion. Mean follow up was 30 months. At the first post-perfusion visit (four to six weeks following perfusion), three of the 22 patients (13.63 per cent) had a pure tone average improvement of at least 10 dB, 15 (68.18 per cent) showed no change and four (18.18 per cent) demonstrated a decrease in hearing of more than 10 dB. Regarding speech discrimination scores, one patient (4.54 per cent) exhibited an improvement of at least 15 per cent, 1.5 (68.18 per cent) showed no change and six (27.27 per cent) showed a decrease of at least 15 per cent. After long-term follow up (12-40 months following perfusion), 10 patients (45.45 per cent) showed stable hearing, and 12 (54.54 per cent) exhibited a pure tone average decrease of more than 10 dB. Six patients (27.27 per cent) showed a speech discrimination score decrease of at least 15 per cent, while 16 (72.72 per cent) had no change. Complete cessation of vertigo was reported by 20 of the 22 patients (90.9 per cent), while two (9.09 per cent) reported episodic vertigo spells.Conclusion: Intratympanic gentamicin perfusion provides effective control of vertigo in patients with Meniere's disease. However, significant hearing loss may occur immediately after perfusion; therefore, this treatment should be considered only for patients whose hearing has already been affected by the disease.