经鼓室微导管持续泵入庆大霉素治疗难治性梅尼埃病

目的 观察经鼓室内微导管持续泵入庆大霉素治疗单侧难治性梅尼埃病的疗效。方法 对21例单侧难治性梅尼埃病患者经耳后进路鼓室内插入微导管，在2天内用微量泵以0．1ml／h的速度注入庆大霉素0．048g，然后观察眩晕、听力及耳鸣的变化。结果 21例平均随访23个月，眩晕完全控制18例，明显减轻3例，其中有2例复发再次治疗后眩晕消失；听力无明显改变有15例，听力平均下降5．1～7．6dB的有5例，听力平均下降10．4dB以上者1例；耳鸣消失者9例，明显减轻者6例，不变者6例。结论 经鼓室微导管持续泵入庆大霉素治疗难治性梅尼埃病，可有效地控制眩晕，改善耳鸣；对听力的损害较轻微，可作为单侧难治性梅尼埃病的首选治疗方法。

Continuous Intratympanic Infusion of Gentamicin via a Microcatheter for the Treatment of Intractable Meniere''''s Disease

Objective To assess the curative effect of a continuous gentamicin infusion into the middle ear via a micromedicine infusion pump for the intractable Meniere's disease.Methods 21 patients were treated by gentamycin dosage of 0.1 milliliter/h continuously applied by a minipump over a period of 2 days. The patients received a total dose of 0.048 g. The results were analysed with a average follow-up of 23 months.Results All patients experienced marked decrease in the frequency and intensity of vertigo. 18 patients no longer suffered from vertigo, while 3 showed symptoms of incomplete compensation. Additionally, two recrudescent patients had no attack of vertigo after gentamicin infusion again. Hearing changes were not detected in 15 patients. Five patients suffered hearing loss ranged from 5.1 to 7.6 dB. One patient had hearing loss of over 10.4 dB. Tinnitus disappeared in 9 patients, while markedly decreased in 6 patients and no change in another 6 patients.Conclusion The new delivery system for gentamicin appears an effective means for controlling intractable vertigo of Meniere's disease or even recrudescent disease. And it also has some effect on tinnitus. Furthermore, it has some mild negative effect on the hearing for the less dosage. Our findings show that the continuous gentamicin application by a minipump is optimum to the unilateral intractable Meniere's disease.