关键词: 梅尼埃病, 眩晕, 鼓膜置管, 鼓室充气, 鼓室注射

Abstract: Objective To explore the efficacy of treating Meniere disease by non-operative serialization through various listening stages. Methods Serialized treatment was conducted in 48 patients with unilateral Meniere disease according to the listening stages. In period Ⅰ, patients received regular diet control, blood vessel expansion, nerve nutrition and vitamin medication. In period Ⅱ, on the basis of conventional treatment, patients were injected with odium succinate 40 mg, once in 3 days for 3 times. If it was not effective, tympanostomy tube and tympanic cavity inflation were administered. In period Ⅲ, on the basis of regular treatment, patients underwent tympanic cavity perfusion after tympanostomy tube and injection of prednisolone sodium of 40 mg, once in 3 days for 3 times, and received inflation treatment in middle ear drum balloon. In period Ⅳ, on the basis of conventional treatment, patients received gentamicin 40 000 U+0.5%, sodium bicarbonate 0.5 mL and tympanic cavity injection once a week. The frequency of injection was commonly 2-3 times a week, determined by circumgyration, hearing changes and situations of tinnitus. For patients who had low vestibular apparatus function, rehabilitation training of vestibular function was provided. Patients’ vertigo, hearing, activity ability and tinnitus changes were followed up for 18-24 months. Results Vertigo was fully controlled in 12 cases, basically controlled in 33 cases, partially controlled in 3 cases, and the clinical effective rate was 93%. The hearing ability was improved to A level in 12 cases(>30 db or the frequency <20 db), to B level in 6 cases(15-30 db), to C level in 29 cases(0-14 db), and to D level in 1 case(improvement <0 db). The mobility was fully controlled in 16 cases(A level), basically controlled in 32 cases(B level), and the effective rate was 100%. The score of Tinnitus Handicap Inventory after treatment was significantly decreased(P<0.05). Conclusion Treatment of Meniere disease vertigo by non-operative serialization through different listening stages can achieve high control rate, and patients’ mobility is apparently improved. For patients in stage Ⅰ and Ⅱ, the tinnitus and hearing are significantly improved. For patients in all stages, tinnitus can be obviously improved. The method is simple and causes few side effects. It can avoid operation risks, and reduce the medical costs.

Key words: Air inflation, Intratympanic injection, Menieres disease, Grommet insertion, Vertigo