Meniere's disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops.
Meniere's disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops.
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DOI：
10.1136/bmjopen-2012-001555
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发表时间：
2013
期刊：
影响因子：
2.9
通讯作者：
Naganawa S
中科院分区：
文献类型：
--
作者：
Pyykkö I;Nakashima T;Yoshida T;Zou J;Naganawa S
评估梅尼埃病和相关内耳内淋巴积水（EH）中眩晕、听力损失和耳鸣的发病情况。三个患者组的多中心评价。对芬兰一家三级转诊医院的转诊患者和芬兰梅尼埃协会的成员进行了疾病特异性症状审查。另一组患者的MRI在日本的三级转诊中心进行。沿着有340名患者和740名梅尼埃协会成员在转诊医院接受了检查。在日本对224例患者进行了MRI检查。梅尼埃病的潜伏期和症状发展，以及单一症状患者和梅尼埃病内耳EH的出现。首发症状的平均年龄为43.8岁，10%的患者年龄超过65岁。 20%的成员和患者的听力损失和眩晕之间的时间延迟超过5年。钆对比MRI显示90%的梅尼埃病患者存在高血压，其中75%的单侧症状患者为双侧高血压。在眩晕、耳鸣或听力损失的单一症状患者中，55-90%的患者在症状耳的耳蜗和/或前庭中证实了EH。梅尼埃病通常表现为双侧EH，包括从单一症状疾病到疾病典型症状复合体的连续体。我们建议在静脉注射钆对比剂后4 h，对感觉神经性听力损失、眩晕和耳鸣患者进行3 T MRI测量，以验证内耳病理。 这可能会导致更好的管理条件。
To evaluate the onset of vertigo, hearing loss and tinnitus in Ménière's disease and the associated endolymphatic hydrops (EH) of the inner ear. Multicentre evaluation of three patient groups. Disease-specific symptoms were reviewed among referred patients in a tertiary referral hospital in Finland and in members of a Finnish Ménière Association in Finland. The MRI of a separate group of patients was undertaken in a tertiary referral centre in Japan. 340 patients were reviewed in the referral hospital along with 740 members of the Ménière Association. MRI was undertaken in 224 patients in Japan. Latency and symptom development in Ménière's disease, and the appearance of EH of the inner ear in monosymptomatic patients and in Ménière's disease. The mean age of the first symptom was 43.8 years, with 10% of the patients being older than 65 years. The time delay between hearing loss and vertigo was more than 5 years in 20% of the members and of the patients. Gadolinium-contrasted MRI demonstrated EH in 90% of the patients with Ménière's disease, in which 75% was bilateral among patients with unilateral symptoms. In monosymptomatic patients with vertigo, tinnitus or hearing loss; EH was demonstrated in 55–90% of the patients either in the cochlea and/or the vestibulum of the symptomatic ear. Ménière's disease often shows bilateral EH and comprises a continuum from a monosymptomatic disease to the typical symptom complex of the disease. We suggest that a 3T MRI measurement should be carried out in patients with sensory-neural hearing loss, vertigo and tinnitus, 4 h after the intravenous injection of a gadolinium-contrast agent to verify the inner ear pathology. This may lead to a better management of the condition.
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影响因子：
3.4
作者：
Havia, M;Kentala, E;Pyykkö, I
通讯作者：
Pyykkö, I
影响因子：
1.7
作者：
Alexander, Thomas H.;Harris, Jeffrey P.
通讯作者：
Harris, Jeffrey P.
影响因子：
1.4
作者：
Levo, Hella;Stephens, Dafydd;Pyykko, Ilmari
通讯作者：
Pyykko, Ilmari
影响因子：
3
作者：
Naganawa, Shinji;Yamazaki, Masahiro;Nakashima, Tsutomu
通讯作者：
Nakashima, Tsutomu
影响因子：
1.7
作者：
Pyykko, Ilmari;Zou, Jing;Naganawa, Shinji
通讯作者：
Naganawa, Shinji