目的 通过对一例双侧梅尼埃病的病情演变、治疗过程和文献复习了解该病的复杂性以及保守治疗方案的作用.方法 结合文献复习对一例明确诊断的,病程30年并随访15年的双侧梅尼埃病患者的病情演变、诊断治疗方案及预后进行分析.结果 患者症状分析及听力检测结果可有效诊断梅尼埃病;保守治疗方案对于早、中期患者效果较好,庆大霉素鼓室注射可用于治疗顽固性眩晕.结论 梅尼埃病的症状复杂且首发症状呈现多样化,单侧病变可随病程迁延向双侧转化;对于临床症状及听力检查结果的分析仍然是对于梅尼埃病的诊断、分期及治疗的基础;双侧梅尼埃病症状及转变的复杂性提示应该慎重选择治疗方案,保守治疗方案对患者是有益的且庆大霉素鼓室注射对于顽固性眩晕具有良好治疗效果.鉴于梅尼埃病的慢性病特点,以及疾病认识的局限,任何激进的、有创性的诊治方法都应审慎.%Objective The objective of this study was to understand the complexity of Meniere's disease and the role of conservative management via studying disease development and treatment options in a case of chronic bilateral Meniere's disease and literature review.Methods Detailed data from a patient with definitely diagnosed bilateral Me-niere's disease of 30 years,including 15 years of follow-up,were carefully reviewed,regarding disease evolution,as-sessment and management procedures,as well as prognosis.Relevant literatures were also reviewed.Results Symptom-atic analysis and hearing tests were helpful in assessing Meniere's Disease.Conservative management was adequate in the early and mid-term stages of the disease.Intratympanic gentamicin injection was useful in controlling intractable vertigo symptoms.Conclusion There are numerous symptoms in Meniere's disease and the presenting symptoms are variable.Unilateral Meniere's disease can progress to involve both sides.Careful assessment of clinical symptoms and audiometry results is still the basis for diagnosis,staging and treatment of Meniere's disease.The complex clinical fea-tures and disease progression patterns in bilateral Meniers's disease demand thoughtful development of treatment plans,with conservative treatments benefiting most patients and intratympanic gentamicin injection being useful for in-tractable vertigo.In view of the chronic-disease characteristics of Meniere's disease,as well as our limited understand-ing,we should be cautious about any radical or invasive diagnostic and treatment methods.
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