Analysis of Hearing Preservation After Endolymphatic Mastoid Sac Surgery for Meniere's Disease
Analysis of Hearing Preservation After Endolymphatic Mastoid Sac Surgery for Meniere's Disease
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DOI：
10.1002/lary.20787
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发表时间：
2010-03-01
期刊：
影响因子：
2.6
通讯作者：
Pensak, Myles L.
中科院分区：
文献类型：
--
作者：
Sun, Gordon H.;Leung, Randal;Pensak, Myles L.
目标/假设：比较药物治疗失败后接受内淋巴乳突囊手术（EMSS）的确诊梅尼埃病患者和仅接受药物治疗的患者的听力结果。研究设计：回顾性分析1997年至2006年期间456例连续患者的听力结果。结果指标为纯音平均值（PTA）、单词识别评分（WRS）和言语接收阈值（SRT）的变化。在58名合格的患者中，29名在药物治疗失败后接受EMSS的患者显示PTA降低4 dB，VMS增加2%，SRT降低2 dB。29例接受药物治疗的患者仅表现出1 dB PTA增加、2% WRS改善和2 dB SRT改善。在治疗后PTA（P = 0.34）或WRS（P = 0.95）的变化方面，药物治疗和手术治疗患者之间没有显著差异。在所有参与研究的患者中，60%的患者的听力没有临床显著变化，而24%的患者听力改善，16%的患者听力恶化。治疗后的听力变化的分布之间的医疗和手术groups.Conclusions：PTA和WRS与药物治疗或EMSS管理的梅尼埃病患者之间的变化没有统计学意义（P = 0.17）。虽然进行EMSS治疗梅尼埃病的眩晕似乎与治疗后听觉功能恶化的风险增加无关，但手术也不会增加稳定或改善听力的可能性。
Objectives/Hypothesis: Comparison of audiometric outcomes between patients with definite Meniere's disease who underwent endolymphatic mastoid sac surgery (EMSS) following failed medical therapy and patients who underwent medical therapy only.Study Design: Retrospective chart review of 456 consecutive patients between 1997 and 2006.Methods: Outcome measures were changes in pure-tone average (PTA), word recognition score (WRS), and speech reception threshold (SRT).Results: Of 58 qualified patients, 29 who underwent EMSS after failing medical therapy showed a 4 dB decrease in PTA, a 2% increase in VMS, and a 2 dB decrease in SRT. Twenty-nine patients treated with medical therapy only demonstrated a 1 dB PTA increase, 2% WRS improvement, and 2 dB SRT improvement. No significant difference was noted between the medically and surgically managed patients in terms of changes in PTA (P = .34) or WRS (P = .95) after treatment. Of all patients in the study, 60% had no clinically significant change in hearing, whereas 24% improved and 16% worsened. The distribution of post-treatment hearing changes between the medical and surgical groups was statistically insignificant (P = .17).Conclusions: The changes in PTA and WRS among patients with Meniere's disease managed with medical therapy or EMSS were not statistically significant. Although performing EMSS to treat the vertigo of Meniere's disease does not appear to be associated with an increased risk of deteriorating auditory function after treatment, surgery also does not confer an increased likelihood of stabilizing or improving hearing.