治疗前庭性眩晕的最新手术方案。

Stefan Volkenstein, Stefan Dazert
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引用次数: 0

摘要

眩晕并不是一种定义明确的疾病,而是一种可发生在不同实体中的症状,主要由耳鼻喉科医生、神经科医生、内科医生和初级保健医生进行诊断和治疗。大多数眩晕综合征的预后良好,治疗方法以保守疗法为主,需要手术治疗的情况很少见,但对于一部分患者来说,手术治疗往往是唯一的选择。在本文中,我们将介绍并讨论针对内耳积水性疾病、梅尼埃病、裂隙综合征、耳周瘘管和良性阵发性位置性眩晕的不同手术治疗方案。最后,我们将简要介绍前庭植入物的最新进展。如今,当保守疗法无法减轻症状,而患者仍在忍受痛苦时,手术疗法仍适用于部分前庭疾病患者。成功与否取决于正确的诊断,以及从不同的手术中选择合适的患者。关于手术的侵入性和可能的风险,深入的个体咨询是绝对必要的。消融性和破坏性手术通常能成功控制眩晕,但也有听力损失的高风险。因此,残余听力必须纳入手术治疗的决策过程中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Recent surgical options for vestibular vertigo.

Recent surgical options for vestibular vertigo.

Recent surgical options for vestibular vertigo.

Recent surgical options for vestibular vertigo.

Vertigo is not a well-defined disease but a symptom that can occur in heterogeneous entities diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine, and primary care physicians. Most vertigo syndromes have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe and discuss different surgical therapy options for hydropic inner ear diseases, Menière's disease, dehiscence syndromes, perilymph fistulas, and benign paroxysmal positional vertigo. At the end, we shortly introduce the most recent developments in regard to vestibular implants. Surgical therapy is still indicated for vestibular disease in selected patients nowadays when conservative options did not reduce symptoms and patients are still suffering. Success depends on the correct diagnosis and choosing among different procedures the ones going along with an adequate patient selection. With regard to the invasiveness and the possible risks due to surgery, in depth individual counseling is absolutely necessary. Ablative and destructive surgical procedures usually achieve a successful vertigo control, but are associated with a high risk for hearing loss. Therefore, residual hearing has to be included in the decision making process for surgical therapy.

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