CAJ | 학술논문

目的探讨迟发性膜迷路积水的诊断和治疗.方法回顾性分析37例(40耳)迟发性膜迷路积水患者的临床资料,包括纯音测听、前庭诱发的肌源性电位(vestibular evoked myogenic potentials,VEMP)、高刺激ABR、前庭双温试验等结果.主要予以利尿剂、血管扩张剂等药物治疗.结果 37例患者均为中、重度以上感音神经性聋.膜迷路积水与听力下降同侧25例,对侧9例,双侧3例.水平半规管和球囊均有积水10例,水平半规管积水9例,球囊积水15例,VEMP和双温试验均正常3例.VEMP正常12例,异常者25例,其中6例患侧p13-n23振幅消失,5例p13潜伏期延长,14例患侧p13-n23低振幅.37例患者中一周内完全控制眩晕发作18例;眩晕明显减轻、二周后完全控制17例;2例行化学迷路切除后眩晕未再发作.结论迟发性膜迷路积水的诊断应依据纯音测听、耳蜗电图、前庭双温试验和前庭诱发肌源性电位等检查结果综合判定;治疗以药物治疗为主,利尿剂和血管扩张剂是主要治疗药物.
목적 탐토지발성막미로적수적진단화치료.방법 회고성분석37례(40이)지발성막미로적수환자적림상자료,포괄순음측은、전정유발적기원성전위(vestibular evoked myogenic potentials,VEMP)、고자격ABR、전정쌍온시험등결과.주요여이이뇨제、혈관확장제등약물치료.결과 37례환자균위중、중도이상감음신경성롱.막미로적수여은력하강동측25례,대측9례,쌍측3례.수평반규관화구낭균유적수10례,수평반규관적수9례,구낭적수15례,VEMP화쌍온시험균정상3례.VEMP정상12례,이상자25례,기중6례환측p13-n23진폭소실,5례p13잠복기연장,14례환측p13-n23저진폭.37례환자중일주내완전공제현훈발작18례;현훈명현감경、이주후완전공제17례;2례행화학미로절제후현훈미재발작.결론 지발성막미로적수적진단응의거순음측은、이와전도、전정쌍온시험화전정유발기원성전위등검사결과종합판정;치료이약물치료위주,이뇨제화혈관확장제시주요치료약물.
Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops(DEH).Methods A restrospective study was conducted in 37 cases of DEH.who were tested with pure tone threshold,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular ruction test.Conservative drug therapy was the major treatment.Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least.Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type.Ten cases had abnormal horizontal semicircular canal(HSCC) hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function.Fifteen cases had abnormal saccular function and normal HSCC function.Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week.17 cases improved until totally relieved in two weeks,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack.Conclusion Pure tone threshold,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops.Consevative drug therapy,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.