Efficacy of endolymphatic duct blockage in treating Ménière's disease
Objective:Ménière's disease(MD)is an idiopathic inner ear disorder characterized by recurrent episodes of episodic rotational vertigo,fluctuating hearing loss,tinnitus,and a feeling of ear stuffiness.Endolymphatic sac(ES)-related surgery is used primarily in patients with MD who have failed to respond to pharmacologic therapy.Endolymphatic duct blockage(EDB)is a new procedure for the treatment of MD,and related clinical studies are still scarce.This study aims to investigate the dynamic changes in endolymphatic hydrops(EH)and the long-term surgical outcomes in MD patients undergoing EDB,and to evaluate the impact of different types of ES on the surgical efficacy.Methods:A retrospective analysis was conducted on 33 patients with refractory MD who underwent EDB.Based on the morphology of their endolymphatic sacs,patients were divided into a normal-type group(n=14)and an atrophic-type group(n=19).The frequency of vertigo symptoms,hearing,vestibular function,and the dynamic changes of gadolinium-enhanced MRI of the inner ear were compared were compared before and after surgery between the 2 groups.Results:Compared with the atrophic-type group,the patients in the normal-type group had a higher rate of complete vertigo control,better cochlear and vestibular function,and a lower endolymph to vestibule volume ratio(all P<0.05).In addition,7 patients in the normal-type group were found to have reversal of EH,while no reversal of EH was detected in the atrophic-type group after surgery.Conclusion:The response to EDB treatment varies between normal and atrophic MD patients,suggesting that the 2 pathological types of endolymphatic sacs may have different underlying mechanisms of disease.
NETL
NSTL
万方数据
