抄録
The managements for severe Meniere's disease (MD) is to accept the presence of the endolymphatic hydrops while attempting to eliminate vertigo itself. For this purpose, either vestibular neurectomy (VN) or streptomycin perfusion (SMP) of the horizontal semicircular canal has been performed to MD patients in our department. Excellent auditory results were confirmed after VN treatment, while hearing became worse after SMP treatment.
In the present study, auditory function (pure tone audiogram: PTA) after the SMP of five MD patients with intractable vertigo was evaluated. SM at a concentration of 25 (n=2) or 50 (n=3)μg/ml was applied into the horizontal semicircular canal. In three cases, the intensive treatment with intravenous injection of methylpredonisolone (total 500mg) or defibrase (40 unit) was followed after SMP.
In 4 cases out of 5 MD patients operated, the avaraged PTA thresholds (at 500, 1000, and 2000 Hz) were elevated to 110 dB after SMP. In two cases, who received 25μg/ml SM andthe intensive treatment with methylpredonisolone or defibrase, the averaged PTA thresholds recoverd from 110dB to 77dB and 84dB after three months (58dB, 64dB before SMP). In other two cases, 50μg/ml SM was applied. One case received the intensive treatment and another case received no treatment.
In both cases, the PTA thresholds showed a relative slow recovery during next three months and recoved from 110dB and 102dB to 100dB and 96dB. In all cases, the recovery was most prominent in the middle frequency, while much less in the lower and higher frequencies.
These results suggest that the auditory impairment after SMP would be reversible and the recovery of auditory function could be accelerated by the intensive treatment with methylpredonisolone or defibrase just after SMP.
