晚期梅尼埃病人工耳蜗植入研究并文献复习

Cochlear implantation in patients of Meniere’s diseasewith sensorineural deafness and literature review

摘要:

目的 回顾性分析5例晚期梅尼埃病致双耳极重度感音神经性耳聋患者行人工耳蜗植入术的效果。方法 2006~2011年收集5例晚期梅尼埃病致双耳极重度感音神经性耳聋患者行人工耳蜗植入术，分析患者的术前资料、术中及术后听力、耳鸣及眩晕情况，并复习文献对梅尼埃病行人工耳蜗植入术的适应证、可行性、术前及术后处理等情况进行讨论。结果 5例患者术中均无“井喷”现象出现，术后听力均恢复良好，语言交流能力明显提高，可进行电话交流；其中3例耳鸣消失，2例耳鸣明显减轻；2例术后数天内出现一过性眩晕，治疗后无再出现眩晕发作。结论 在眩晕得到控制的前提下，晚期梅尼埃病致双耳极重度感音神经性聋的患者行人工耳蜗植入是可行的，但其确切疗效和转归仍需大宗病例及长期追踪随访。

Abstract:

Objective To evaluate the effect of cochlear implantation on patients with binaural extremely severe sensorineural hearing loss induced by Meniere’s disease. Methods Five patients included in the study were diagnosed as having Meniere’s disease as well as bilateral severe to profound sensorineural hearing loss as an indication for cochlear implantation from 2006 to 2011. Clinical data including preoperative audiologic information, intraoperative and postoperative auditory and vestibular function rehabilitation were analyzed retrospectively. The indication, feasibility, preand postoperative management of cochlear implantation in patients with Meniere’s disease was discussed with literature review. Results All the patients underwent cochlear implantation under the condition of vertigo being controlled. No “gusher” phenomenon and postoperative vertigo appeared. Their hearing recovered well after surgery, language communication ability improved apparently. Tinnitus disappeared in 3 cases and reduced in the other 2. Two cases experienced transient postoperative vertigo and got recovered after treatment. Conclusion The cochlear implantation may be the direction for the patients with bilateral Meniere’s disease who had progressing profound sensorineural hearing loss. The technique and theory are feasible, but the experience is limited and the curative effect also needs more cases to sum up and longterm observation.