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目的评估内淋巴囊引流术治疗梅尼埃病的远期疗效。方法选择1987年3月至2004年9月住院的接受内淋巴囊引流术治疗的梅尼埃病患者共26例,对随访2年以上、资料完整的18例进行了回顾性总结。其诊断和疗效评价均依据1996年中华医学会耳鼻咽喉科学分会和中华耳鼻咽喉科杂志编辑委员会制订的梅尼埃病诊断依据和疗效分级标准。结果 18例患者随访2～13年,其中2～5年2例,≥5年16例;平均9.28年。18例患者术后眩晕 A 级(完全控制)9例(50%),B 级(大部分控制)8例(44.4%),D 级(加重)1例(5.6%);耳鸣消失2例(11.1%),减轻9例(50%),无效7例(38.9%);耳闷胀感消失10例(55.6%),无效8例(44.4%);听力提高(A+B级)6例(33.3%),无明显变化(C 级)4例(22.2%),下降(D 级)8例(44.5%)。手术后均无面神经麻痹、脑脊液瘘、出血、切口感染等并发症。结论内淋巴囊引流手术是治疗梅尼埃病安全有效的方法,大部分病例术后听力得以保存。
Objective To assess the long-term efficacy of endolymphatic drainage in the treatment of Meniere’s disease. Methods A total of 26 patients with Ménière’s disease undergoing endolymphatic drainage in our hospital from March 1987 to September 2004 were retrospectively reviewed. The data of 18 patients who were followed up for more than 2 years were retrospectively reviewed. The diagnosis and evaluation of efficacy were based on the diagnostic criteria and efficacy classification criteria of Meniere’s disease formulated by the Department of Otorhinolaryngology, Chinese Medical Association and the Editorial Board of Chinese Academy of Otolaryngology, 1996. Results 18 patients were followed up for 2 to 13 years, of which 2 to 5 years in 2 cases, ≥ 5 years in 16 cases; an average of 9.28 years. Nine patients (50%) underwent grade A (complete control), eight patients (44.4%) underwent grade B (most of the patients) and one patient (5.6%) underwent dizziness (n = 2) 11.1%), 9 cases (50%) were alleviated, 7 cases (38.9%) were ineffective, 10 cases (58.6% (33.3%), no significant change (grade C) in 4 cases (22.2%), decreased (grade D) in 8 cases (44.5%). No facial paralysis after surgery, cerebrospinal fluid fistula, bleeding, incision infection and other complications. Conclusion Endolymphatic drainage is a safe and effective method for the treatment of Meniere’s disease, and the hearing of most cases can be preserved.