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目的:评估与比较内淋巴囊乳突腔分流术(EMS)和内淋巴囊减压术(ESD)治疗梅尼埃病(MD)的远期疗效。方法:1994-06-2007-07采用内淋巴囊手术治疗原诊断为MD的患者59例,其中EMS34例,ESD25例,选择诊断符合MD诊断依据和疗效评估标准,术后2年以上、随访资料完整的23例24耳(分流术12例13耳,减压术11例11耳)进行回顾性总结。结果:EMS组12例13耳,随访3～14年,眩晕A级完全控制者9耳,B级基本控制4耳;ESD组11例11耳,随访2～14年,术后眩晕A级8耳,B级2耳,C级1耳。EMS组听力B级1耳(7.7%),C级6耳,D级6耳;ESD组听力B级2耳(18.2%),C级4耳,D级5耳。2组眩晕控制和听力改善差异无统计学意义。结论:EMS和ESD都是治疗MD的有效方法,对眩晕症状的控制效果满意,临床分期中晚期患者仍有疗效。
OBJECTIVE: To assess and compare the long-term efficacy of endolymphatic sac shunt (EMS) and endolymphatic sac decompression (ESD) in the treatment of Meniere’s disease (MD). Methods: From June 1994 to July 2007, 59 patients with MD diagnosed by endolymphatic sac surgery were selected, including 34 cases of EMS and 25 cases of ESD. The diagnostic criteria were consistent with the criteria of MD diagnosis and evaluation of curative effect. After 2 years and more follow-up data Complete 23 cases of 24 ears (shunt 12 cases of 13 ears, 11 cases of decompression 11 ears) were retrospectively summarized. Results: In the EMS group, 12 ears (13 ears) were followed up for 3 to 14 years, 9 ears were completely A-level vertigo control, 4 ears were B-level control basically. 11 cases of ESD group were followed up from 2 to 14 years, Ear, B 2 ears, C 1 ears. In the EMS group, B (1) ears (7.7%), C (6 ears) and D (6 ears) were classified into two groups. The ESD group had 2 ears (18.2%) with grade B, 4 ears with C grade and 5 ears with D grade. There was no significant difference between the two groups in vertigo control and hearing improvement. Conclusion: Both EMS and ESD are effective methods for the treatment of MD. Satisfactory results are obtained in the control of dizziness symptoms. The patients in the advanced stage of clinical staging are still effective.