平衡协会和日本平衡研究协会的第三次联合会议

预测从单侧发展到双侧梅尼埃病的因素

Munetaka USHIO1，Shinichi IWASAKI2，Naoya EGAMI2，Keiko SUGASAWA2，Atsushi KINOSHITA2，Chisato FUJIMOTO1，Toshihisa MUROFUSHI3，Tatsuya YAMASOBA2

1 日本，JCHO东京大和医学中心耳鼻喉科学系

2 日本，东京大学耳鼻喉科学系

3 日本，帝京大学医学院沟口医院耳鼻喉科学系

在梅尼埃病病程中，约1/3的患者会逐渐从单侧发展到双侧梅尼埃病。为了最优的治疗，有关的对侧耳部潜在的风险应该被评估。这项研究致力于探究能够预测从单侧发展到双侧梅尼埃病的因素。

回顾性分析确定诊断为MD的180位连续的患者临床记录。患者被分为以下三组：患者患有单侧MD（CEI-累及对侧耳部），患者从单侧发展到双侧MD（CEI+），患者从第一次就诊开始就患有双侧MD（BL，双侧）。年龄、性别、症状的衰减、疾病的阶段、冷热试验中左右的差别、前庭诱发肌源性电位结果（VEMP）、主观水平视觉、眩晕缓解的时间等都被比较。

当阶段1和阶段2合并、阶段3和阶段4合并，阶段3或阶段4的病例在CEI+和BL组都比CEI-组有更多的患者。对于VEMP，很大一部分患者在两侧都展示了正常的反应或者在CEI+和BL组两侧缺失的反应都比CEI-组更多。在回归分析中，阶段3或阶段4、以及VEMP中左右差别的缺失是与对侧耳部累及密切相关的因素。

对于单侧MD的患者，疾病3、4阶段以及在初始检查时VEMP反应中左右差别的缺失是对侧耳部累及的危险因素。

The 3rd Joint Meeting of The Korean Balance Society and Japan Society for Equilibrium Research

FACTORS PREDICTING PROGRESSION FROM UNILATERAL TO BILATERAL MENIERE’S DISEASE

Munetaka USHIO1, Shinichi IWASAKI2, Naoya EGAMI2, Keiko SUGASAWA2, Atsushi KINOSHITA2, Chisato FUJIMOTO1, Toshihisa MUROFUSHI3, Tatsuya YAMASOBA2

1 Department of Otolaryngology, JCHO Tokyo Yamate Medical Center, Japan

2 Department of Otolaryngology, the University of Tokyo, Japan

3 Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Japan

In the course of Meniere’s disease (MD), approximately one third of patients progress from unilateral to bilateral  MD. For optimal treatment, the potential risk for contralateral ear involvement should be properly assessed. This study aimed to explore factors predicting progression from unilateral to bilateral Meniere’s disease.

Clinical records of 180 consecutive patients with definite MD were reviewed. Patients were classified into the following 3 groups: patients with unilateral MD (CEI-, contralateral ear involvement), patients exhibiting progression from unilateral to bilatera lMD (CEI+), and patients with bilateral MD at the time of first consultation (BL, bilateral ). Age, gender, duration of symptoms, stage of disease, left-right difference on caloric test, results of vestibular-evoked myogenic potential (VEMP) recording, subjective visual horizontal, and time to remission of vertigo attacks were compared.

When stages 1 with 2 and 3 with 4 were combined, there were more cases of stage 3 or 4 disease in both the CEI+ and BL groups than in the CEI-group. On VEMP responses, the proportions of patients exhibiting normal responses on both sides or absent responses on both sides in the CEI+ and BL groups were larger than those in the CEI- group. In regression analysis, stage of 3 or 4 and lack of left-right difference in VEMP response were factors significantly associated with contralateral ear involvement.

In patients with unilateral MD, stage 3 or 4 disease and lack of left -right diffrence in VEMP responses at initial examination were risk factors for contralateral ear involvement.

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