内淋巴囊减压联合部分半规管填塞术治疗Ⅲ、Ⅳ期梅尼埃病的临床观察

Clinical Effect of Endolymphatic Sac Decompression Combined with One or Two Semicircular Canal Obstruction in the Treatment of Stage Ⅲ or Ⅳ Meniere Disease

张国平;王楠;张粉;蒋佳霖;冯书怡;周义德

1:中国人民解放军海军军医大学第一附属医院耳鼻咽喉头颈外科

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摘要

目的观察内淋巴囊减压联合一个或两个半规管填塞术治疗Ⅲ、Ⅳ期梅尼埃病患者的临床效果及听力损失情况。方法收集经规范性保守治疗无效的、且有保留残余听力期望的Ⅲ、Ⅳ期梅尼埃病患者43例，按手术方式不同分成三组：内淋巴囊减压联合后外两个半规管填塞术组13例，内淋巴囊减压联合外半规管填塞术组14例，单纯淋巴囊减压术组16例，评估三组患者手术前后的眩晕、耳闷、耳鸣及听力情况。结果内淋巴囊减压联合后外两个半规管填塞术组、内淋巴囊减压联合外半规管填塞术组、单纯内淋巴囊减压术组术后眩晕发作次数均明显降低，眩晕控制率分别为92.3%、78.6%及62.5%;眩晕的严重程度也均较术前显著减轻，其中联合半规管填塞术的两组患者术后眩晕改善率(100%)显著高于单纯内淋巴囊减压组(68.8%)。三组患者的耳鸣、耳闷均较术前显著改善，耳鸣改善率分别为46.2%,50.0%及43.8%,耳闷改善率分别为61.5%,57.1%及50.0%,组间差异均无统计学意义。三组中术后听力下降患者的比例分别是15.4%、7.1%、18.8%,差异无统计学意义。结论内淋巴囊减压联合部分半规管填塞术能够有效控制经保守治疗无效的Ⅲ、Ⅳ期梅尼埃病患者的眩晕等症状，并能够在很大程度上保留残余听力，避免极重度感音神经性聋的发生。

关键词

梅尼埃病;内淋巴囊减压术;半规管填塞术;眩晕

基金项目(Foundation):

海军军医大学第一附属医院234学科攀登计划(2020YXK037);; 海军军医大学基础医学研究课题(2022QN054)

作者

张国平;王楠;张粉;蒋佳霖;冯书怡;周义德

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