摘要
目的:分析小剂量庆大霉素鼓室内注射治疗难治性梅尼埃病眩晕的疗效。方法:19例单侧难治性梅尼埃病患者显微镜下鼓室内注射庆大霉素,根据床旁试验(自发性眼震、摇头实验、甩头试验),听力变化或患者主观症状来决定3周后是否需要再次注射。结果:19例患者中17例眩晕能得到控制,眩晕控制率89%,其中5例患者经1次注射后眩晕就得到控制;8例患者2次注射后眩晕达到控制,其中1例患者因不能忍受耳内肿胀感,要求进一步治疗,行内淋巴囊减压后,症状缓减;有4例患者经3次注射后眩晕得到控制;另外2例患者注射2次后眩晕无改善,要求终止治疗。2例患者注射后听力好转,14例患者注射后听力无变化,3例患者(15%)注射后听力进一步下降。结论:运用小剂量鼓室内庆大霉素注射治疗难治性梅尼埃病眩晕,1次注射后观察3周决定再次注射的必要性,结果显示这一治疗方案既能有效控制眩晕的发作,又能降低听力损伤的风险。
Objective：To explore the efficacy of small dose of intratympanic gentamicin injection on intractable Meniere＇s disease. Method： Retrospectively study the efficacy of gentamicin intratympanic injection on intractable Meniere＇s disease. The end-point of treatment was determined based on bedside tests （Spontaneous Nystagmus test, Head shaking test and Head Thrust test）, hearing tests, or the improvement of patients＇ symptoms. Result： Nineteen patients with Meniere＇s disease were treated with intratympanic gentamicin injection. Vertigo control was achieved in 17 patients（89%）. Of them, vertigo of 5 patients was successfully controlled after single injection. Eight patients need double injections and 4 patients need the third injections to control the vertigo. Endolymphatic sac shunt was performed to 1 patient because he could not tolerate the fullness of ear due to injection. The remainder 2 patients with double injections showed no improvement of vertigo and rejected further treatment. Hearing was improved in two patients after gentamicin injection. Three patients complained of hearing loss after intratympanic gentamicin injection. The hearing of the other patients did not change. Conclusion：Three weeks after using small dose of gentamicin intratympanic injection to treat intractable Meniere＇s disease, it was determined whether more injections is required. The results showed that by using this approach, the vertigo could be effectively controlled and the risk of hearing loss following intratympanic gentamicin injection could be reduced.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第4期151-153,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
上海市卫生局科技发展基金项目(No:034099
DCF)
国家科委"十五"攻关资助项目(No:2004BA702B04
DCF
2004BA720A18-01
CFL)
关键词
梅尼埃病
眩晕
庆大霉素
鼓室内注射
Meniere＇s disease
Vertigo
Gentamicin
Intratympanic injection
