内淋巴囊乳突腔分流术治疗梅尼埃病

目的 探讨内淋巴囊乳突腔分流术治疗梅尼埃病的效果。方法 对48例眩晕发作典型，甘油试验阳性，经过1年以上药物治疗无效的梅尼埃病患者采用了内淋巴囊乳突腔分流术进行治疗。结果 经2年以上观察，控制眩晕达A级B级者36例占75％；无效和加重的D级E级5例占10．4％；听力提高达A级B级19例占39．6％，听力稳定在C级者25例占52％，听力恶化的4例占8．3％；耳鸣消失6例，好转9例，有效者占31．3％；耳闷胀感消失43例。11例选用硅胶片引流内淋巴者术后出现了较重眩晕、眼震症，37例选用银夹引流者术后反应轻微。结论 内淋巴囊乳突腔分流术对甘油试验阳性的梅尼埃病患者在控制眩晕、提高听力方面有较好作用，对耳鸣效果较差。内淋巴引流物可选用术后反应轻微的神经外科银夹。

TREATMENT OF MENIERE'' S DISEASE BY THE METHOD OF INNER LYMPHOCYSTO-MASTOID CAVITY SHUNT

Objective To investigate the effects of the treatment of Meniere's disease. by means of the method of inner lymphocyto-mastoid cavity shunt. Methods 48 cases of patients who suffered from Meniere's disease and showed typical vertigo, positive glycerin test and no effect to drug treatment beyond 1 year were selected to receive inner lymphocycto-mastoid cavity shunt. Results 2 years of observation showed that vertigo controlled A and B degree occupied 36 cases (75%); no effect and becoming severe D and E degree occupied 5 cases (10.4%); audition improved A and B degree occupied 19 cases (39.6%); audition stable C degree was 25 cases occupied 52%; audition becoming severe 4 cases (8.3%); tinnitus disappeared 6 cases, becoming better 9 cases and effectives were 31.3%; ear turgid disappeared 43 cases, 11 cases who received inner lymph-fluid drainage by silica gel fragment manifested as heavier vertigo and nystagmus; 37 cases who received silver clip drainage showed slighter reaction. Conclusion Inner lymphocysto-mastoid cavity shunt showed good effect for glycerin test positive patients suffered from Meniere's disease and it could control the vertigo and improve the audition. But it showed worse effect on tinnitus. Neurosurgery silver clip could be used for inner lymph-fluid drainage as it having slighter reaction.