Clinical long-term effects of surgical treatment for intractable Meniere's disease: a more than 13-year follow-up after pressure treatment and further surgical treatment for intractable vertigo.

COMBINED modality therapy; EAR surgery; PATIENT aftercare; MENIERE'S disease; SEMICIRCULAR canals; PSYCHOLOGICAL stress; TREATMENT effectiveness; VERTIGO; SEVERITY of illness index; DESCRIPTIVE statistics; ENDOLYMPHATIC sac; DISEASE complications

Background: Meniere's disease appears to be a complex inner ear disorder and also remains a controversial and often difficult disease as regards determination of diagnosis, pathogenesis and especially optimal treatment. Aims/objectives: To investigate the long-term effects of progressive surgical treatment in the management of the vertigo attacks of intractable Meniere's disease. Material and methods: Eighteen patients with medically intractable and active Meniere's disease were opted to try Meniett pulse generator (Meniett), endolymphatic sac decompression (ESD) and triple semicircular canal occlusion (TSCO) in order to control the attacks of vertigo. Patients were indicated on the symptom report card the maximum level of vertigo, activity and stress. Results: Of 18 patients with medically intractable and active Meniere's disease during mean 165-month follow-up, the attacks of vertigo were effectively controlled in 14 patients by Meniett (77.78%), 2 patients by Meniett and ESD (11.11%), 2 patients by Meniett, ESD and TSCO (11.11%). Conclusions and significance: It is of great importance for intractable Meniere's disease to select surgically combined treatment process including Meniett, ESD and TSCO to effectively control the attacks of vertigo and a long-term follow-up. [ABSTRACT FROM AUTHOR]

背景：梅尼埃病似乎是一种复杂的内耳疾病。在其诊断和发病机制, 特别是最佳治疗方面, 仍然是一种有争议且常常是难治的疾病。 目的：探讨渐进式手术治疗对治疗顽固性梅尼埃病的眩晕发作的长期效果。 材料和方法：对于18名患有难治性和活动性梅尼埃病的患者, 选择使用Meniett脉冲发生器（Meniett）、内淋巴囊减压术（ESD）和三重半规管闭塞术（TSCO）来控制眩晕的发作。在症状报告卡上显示患者的最大程度的眩晕、活动和压力。 结果：在平均165个月随访期间, 18名患有难治性和活动性梅尼埃病的患者中, 14名患者使用Meniett有效控制了眩晕发作（77.78％）, 两名使用Meniett和ESD（11.11％）, 两名使用了 Meniett、ESD和TSCO（11.11％）。 结论和意义：对于顽固性梅尼埃病, 选择包括Meniett、ESD和TSCO的联合手术治疗对于有效控制眩晕的发作, 并长期随访具有重要意义。 [ABSTRACT FROM AUTHOR]

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