半规管阻塞加内淋巴囊减压治疗顽固性梅尼埃病

Semicircular Canal Plugging Based on Endolymphatic Sac Decompression:The Surgical Technique Discussion for Intractable Meniere's Disease

宋任东;杨凤;肖跃华;李明晏;刘阳;

1:河北省保定市第二中心医院耳鼻喉科

2:海军总医院耳鼻喉科

摘要
目的探讨三个半规管阻塞加内淋巴囊减压治疗顽固性梅尼埃病的疗效,并总结手术要点。方法中晚期单侧梅尼埃病患者14例,术前0.25、0.5、1、2kHz骨导听阈3565dB HL;14例均在全麻下完成内淋巴囊减压术,同时磨开三个半规管骨质成骨性小窗,以软组织填塞半规管管腔;术后随访365dB HL;14例均在全麻下完成内淋巴囊减压术,同时磨开三个半规管骨质成骨性小窗,以软组织填塞半规管管腔;术后随访318月,评估患者眩晕控制情况以及听力、耳鸣的变化。结果 14例均顺利完成手术,术后均无面瘫及脑脊液漏,除1例失访外,余13例均未再发生眩晕;8例听力较术前无变化,5例语言频率平均骨导听力较术前下降1018月,评估患者眩晕控制情况以及听力、耳鸣的变化。结果 14例均顺利完成手术,术后均无面瘫及脑脊液漏,除1例失访外,余13例均未再发生眩晕;8例听力较术前无变化,5例语言频率平均骨导听力较术前下降1015dB;10例耳鸣无变化,1例耳鸣变为偶发,2例耳鸣加重。结论半规管阻塞加内淋巴囊减压术对中、晚期梅尼埃患者中短期眩晕控制良好,但内淋巴囊减压并不能缓解半规管阻塞引起的听力损失风险。
关键词
梅尼埃病;内淋巴囊减压;半规管阻塞
基金项目(Foundation):
河北省医学科学研究重点课题计划(20150009)资助
作者
宋任东;杨凤;肖跃华;李明晏;刘阳;
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