메니에르병에서 내림프낭 감압술과 고실 내 겐타미이신 주입술 치료법 비교
A Comparison of Endolymphatic Sac Decompression and Intratympanic Gentamicin for Treatment of Meniere’s Disease
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Background and Objectives Meniere’s disease (MD) is primarily managed by lifestyle anddietary changes. There are several non-medical treatment options for medically intractableMD; however, treatment results still remain controversial. This study aims to review the treatmentoutcome of endolymphatic sac decompression (ESD) and intratympanic gentamicin(ITG) for MD refractory to medical management. Subjects and Method The medical records of 50 patients, diagnosed with definite MD intractableto medical management, who underwent ESD or ITG from 2010 to 2020 at a tertiaryreferral hospital, were retrospectively reviewed. ESD was first considered in patients with serviceablehearing (pure tone audiometry average value less than 50 dB, speech discriminationscore of 50% or greater). One-year post-treatment audiological changes and vertigo controlwere reviewed and compared between the two groups. Results Fifty patients (ears) were enrolled in this study (ESD, n=27; ITG, n=23). There wasa post-treatment hearing gain (2.3 dB HL) in the ESD group (p=0.509), while there was anoverall post-treatment hearing decline (2.2 dB HL) in the ITG group (p=0.178), with no significantdifference between two groups regarding hearing change (p=0.212). Regarding vertigocontrol, 66.6% and 56.5% patients in the ESD and ITG groups, respectively, were classified asvertigo class A or B, with statistically significant difference between both groups (p=0.027). Conclusion ESD conferred better post-treatment vertigo control than ITG, but there wereno significant hearing changes in both groups. ESD is an effective treatment for patients withmedically intractable MD who has serviceable hearing.
Abstract
Background and Objectives Meniere’s disease (MD) is primarily managed by lifestyle anddietary changes. There are several non-medical treatment options for medically intractableMD; however, treatment results still remain controversial. This study aims to review the treatmentoutcome of endolymphatic sac decompression (ESD) and intratympanic gentamicin(ITG) for MD refractory to medical management. Subjects and Method The medical records of 50 patients, diagnosed with definite MD intractableto medical management, who underwent ESD or ITG from 2010 to 2020 at a tertiaryreferral hospital, were retrospectively reviewed. ESD was first considered in patients with serviceablehearing (pure tone audiometry average value less than 50 dB, speech discriminationscore of 50% or greater). One-year post-treatment audiological changes and vertigo controlwere reviewed and compared between the two groups. Results Fifty patients (ears) were enrolled in this study (ESD, n=27; ITG, n=23). There wasa post-treatment hearing gain (2.3 dB HL) in the ESD group (p=0.509), while there was anoverall post-treatment hearing decline (2.2 dB HL) in the ITG group (p=0.178), with no significantdifference between two groups regarding hearing change (p=0.212). Regarding vertigocontrol, 66.6% and 56.5% patients in the ESD and ITG groups, respectively, were classified asvertigo class A or B, with statistically significant difference between both groups (p=0.027). Conclusion ESD conferred better post-treatment vertigo control than ITG, but there wereno significant hearing changes in both groups. ESD is an effective treatment for patients withmedically intractable MD who has serviceable hearing.
참고문헌 (26)
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