A Historical Perspective on Surgical Manipulation of the Membranous Labyrinth for Treatment of Meniere's Disease.
A Historical Perspective on Surgical Manipulation of the Membranous Labyrinth for Treatment of Meniere's Disease.
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DOI：
10.3389/fneur.2021.794741
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发表时间：
2021
影响因子：
3.4
通讯作者：
Ward BK
中科院分区：
文献类型：
--
作者：
Kersbergen CJ;Ward BK
梅尼埃病是一种病因不明的内耳疾病。内淋巴积水是一种内淋巴间隙肿胀，在有梅尼埃病病史的患者尸检组织学上一直观察到，但也可发生在无症状个体中，并与其他疾病相关。自发现以来，梅尼埃病一直是一种主要由耳鼻喉科医生治疗的疾病。因此，外科治疗伴随着医学管理的尝试。受患者耳满感和后来组织学发现的耳积水的启发，外科医生开始操纵膜迷路以缓解眩晕发作，同时试图保留听力。这篇综述强调了膜迷路的操作历史。这些程序显示了丰富的创新历史，与耳科手术的发展平行。涉及患者的研究都是回顾性的，其中一些手术首先在内淋巴积水的动物模型中进行。许多方法得到了著名的耳科医生的认可。如今，一些外科医生在内淋巴囊上进行外科手术;然而，通过微创技术，在许多情况下仅使用局部麻醉剂进行的膜迷路上的手术导致了类似的症状缓解。梅尼埃病患者的发作性眩晕是一种令人痛苦的症状，但自发缓解是常见的。本文回顾的膜迷路手术报告一致表明眩晕发作较少。这些手术后常见不同程度的听力损失，其中许多被放弃。更多的创新手术是不可避免的，但我们必须更好地了解内淋巴积水，梅尼埃病的病理生理学和患者症状之间的关系。
Meniere's disease is an inner ear disorder without a known cause. Endolymphatic hydrops is a swelling of the endolymph spaces that has been observed consistently on post-mortem histology in patients with a history of Meniere's disease but can occur in asymptomatic individuals and in association with other diseases. Since its discovery, Meniere's disease has been a disorder managed primarily by otolaryngologists. Surgical treatments, therefore, have accompanied attempts at medical management. Inspired by patients' sensations of ear fullness and later by the histologic findings of hydrops, surgeons began manipulating the membranous labyrinth to relieve episodes of vertigo while attempting to preserve hearing. This review highlights this history of manipulation of the membranous labyrinth. These procedures indicate a rich history of innovation that parallels developments in otologic surgery. The studies involving patients are uniformly retrospective, with some procedures performed first in animal models of endolymphatic hydrops. Many approaches were endorsed by eminent otologic surgeons. Surgeries on the endolymphatic sac are performed by some surgeons today; however, procedures on the membranous labyrinth resulted in similar symptomatic relief through a minimally invasive technique, in many cases performed using only local anesthetic. Episodic vertigo in patients with Meniere's disease is a distressing symptom, yet spontaneous remissions are common. The reports of procedures on the membranous labyrinth reviewed here consistently indicated fewer vertigo episodes. Variable degrees of hearing loss were common following these procedures, and many were abandoned. Additional innovative surgeries are inevitable, but we must understand better the relationships among endolymphatic hydrops, Meniere's disease pathophysiology, and patient symptoms.
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影响因子：
2.1
作者：
Gluth, Michael B.
通讯作者：
Gluth, Michael B.
影响因子：
1.4
作者：
KIMURA, RS
通讯作者：
KIMURA, RS
影响因子：
2.6
作者：
KINNEY, WC;NALEPA, N;KINNEY, SE
通讯作者：
KINNEY, SE
影响因子：
--
作者：
Baloh, RW
通讯作者：
Baloh, RW
DOI：
10.1017/s0022215100058230
发表时间：
1961-07-01
期刊：
The Journal of laryngology and otology
影响因子：
--
作者：
FEMENIC, B
通讯作者：
FEMENIC, B