Efficacy of endolymphatic duct blockage in treating Ménière's disease
10.11817/j.issn.1672-7347.2024.240376
- VernacularTitle:内淋巴管夹闭术治疗梅尼埃病的效果
- Author:
Tao YANG
1
;
Zhiwen ZHANG
;
Qin WANG
;
Anquan PENG
;
Wei LI
Author Information
1. 中南大学湘雅二医院耳鼻咽喉头颈外科,长沙 410011;湖南省耳科临床医学研究中心,长沙 410011;中南大学湘雅二医院桂林医院耳鼻咽喉科,广西桂林 541002
- Keywords:
Ménière's disease;
endolymphatic duct blockage;
vertigo;
endolymphatic sac;
endolymphatic hydrops
- From:
Journal of Central South University(Medical Sciences)
2024;49(5):712-720
- CountryChina
- Language:Chinese
-
Abstract:
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.
