Results of singular neurectomy in the posterior ampullary recess
Results of singular neurectomy in the posterior ampullary recess
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DOI：
10.1159/000067572
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发表时间：
2002-11-01
期刊：
影响因子：
--
通讯作者：
Gacek, MR
中科院分区：
文献类型：
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作者：
Gacek, RR;Gacek, MR
目的：目的：探讨后半规管壶腹窝内良性阵发性位置性眩晕（BPPV）行单侧神经切除术（SN）后对听力和平衡症状的影响。研究设计：回顾了242例慢性致残性BPPV患者的病历，这些患者在29年的时间里（1972-2001）接受SIN治疗。记录BPPV缓解情况及听功能变化。详细描述了进入后壶腹隐窝以暴露SN的16例患者子集对听力和平衡的影响。结果：242例患者共进行了252次SN。10例患者依次接受双侧SN;其余232例患者接受单侧SN。患者的年龄范围为21至86岁，平均年龄为57岁。男女比例为174：68。BPPV完全缓解244例（96.8%），不完全缓解3例（1%），无缓解5例（2%）。9例患者（3.7%）发生感音神经性听力损失（SNHL）。SN期间打开壶腹隐窝的16例患者的亚组年龄范围为21 - 79岁，平均年龄为56岁。男女比例为12：4，左右两侧几乎相等。16例患者BPPV均得到缓解，无听力损失。5名患者抱怨术后瘘反应（31%）。所有5例患者的瘘管反应均在术后6个月消退。结论：SN可有效缓解BPPV，SNHL风险较小（3.7%）。当必须进入后壶腹隐窝以切断单根神经时，SNHL的风险不会增加。近三分之一的患者可能暂时出现瘘管阳性反应。版权所有（C）2002 S. Karger AG，巴塞尔。
Objective: To determine the effect on hearing and balance symptoms following singular neurectomy (SN) for benign paroxysmal positional vertigo (BPPV) in the ampullary recess of the posterior semicircular canal. Research Design: The charts of 242 patients with chronic disabling BPPV who were treated with SIN over a 29-year period (1972-2001) were reviewed. The results on relief of BPPV and hearing function were recorded. A subset of 16 patients where the posterior ampullary recess was entered to expose the SN is described in detail with regard to an effect on hearing and balance. Results: A total of 252 SN were performed in 242 patients. Ten patients underwent bilateral SN sequentially; the remaining 232 patients had unilateral SN. The ages of the patients ranged from 21 to 86 years, with a mean at 57 years. The female:male ratio was 174:68. Complete relief of BPPV was achieved in 244 patients (96.8%), incomplete relief in 3(1%), and no relief in 5 (2%). Sensorineural hearing loss (SNHL) occurred in 9 patients (3.7%). A subset of 16 patients in whom the ampullary recess was opened during SN ranged in age from 21 to 79 years, with a mean at 56 years. The female:male ratio was 12:4, with right and left sides divided almost equally. Relief of BPPV was achieved in all 16 patients with no loss of hearing function. Five patients complained of a fistula response postoperatively (31%). The fistula response resolved by 6 months postoperatively in all 5 patients. Conclusions: SN is effective in relief of BPPV with little risk of SNHL (3.7%). The risk of SNHL is not increased when the posterior ampullary recess must be entered in order to transect the singular nerve. A positive fistula response may be present temporarily in almost one third of these patients. Copyright (C) 2002 S. Karger AG, Basel.