Study On The Relationship Between Endolymphatic Sac Decompression In The Treatment Of Meniere’s Disease And Vestibular Migraine

Objective:Meniere disease and Vestibular Migraine are common recurrent vertigo diseases.At present,both diseases rely on symptom diagnosis,and there is no laboratory examination as the basis for diagnosis.However,there are similarities in the etiology,inducement and clinical manifestations of the disease.According to the relevant literature,it is reported that the common incidence of the two diseases can be as high as 64.1%.This study explored the efficacy of endolymphatic sac decompression in the treatment of Meniere’s disease with Vestibular Migraine.To provide a micro-innovative treatment method for some patients with Vestibular Migraine who are ineffective by conservative treatmentMethods:The clinical data of 46 patients treated in the outpatient clinic of Otorhinolaryngology head and neck surgery Center of Dalian Central Hospital from October 2017 to October 2019 were collected.25 patients were diagnosed as Meniere disease,including 11 males and 14 females,with an average age of 49.2 years.21 patients were diagnosed as Meniere’s disease and Migraine-Meniere ’s disease,including 5 males.There were 16 females with an average age of 37.5 years.The diagnosis of MD was based on the 2006 Guiyang standard of the Otorhinolaryngology Branch of the Chinese Medical Association,and the diagnosis of VM was based on the diagnostic criteria of the International headache Association(ICHD headache III)in 2013.All the patients voluntarily participated in the study and signed the informed consent form.According to the analysis of the patient’s medical history and clinical data,comprehensive physical examination(including otorhinolaryngology)and relevant auxiliary examination,the age,sex and family history of the patients in the MD group and the diagnosed MMD group were compared at the same time.All patients passed detailed medical history inquiry and otoscopy,followed by pure tone audiometry and acoustic immittance test.Electronystagmogram of temperature change test,video head pulse test(vHIT),and vestibular evoked myogenic potentials were examined in some patients.After conservative treatment for more than half a year,there was no obvious effect,which seriously affected work,study and life.Surgical endolymphatic sac decompression(ESD)was performed after admission.At the same time,all patients were advised to make lifestyle changes,and the patients were followed up for 6 to 9 months.The contents of follow-up included:questionnaire,revisit,etc.,and the data were analyzed retrospectively.According to the evaluation of treatment effect,the control of vertigo before and after operation(times,days and degree of vertigo),hearing and the improvement of work quality were compared.All patients were followed up after operationResults:According to the statistical analysis of the control of vertigo in migraine group and without migraine group,the cumulative number of vertigo attacks in 3 months before and after operation decreased from(17.78±4.125)to(2.07±1.306),in migraine group from(21.00±3.834)to(2.19±1.289),and in without migraine group from(15.08±1.730)to(1.96±1.338).The cumulative days of vertigo before and after treatment decreased from(14.37±2.768)to(1.52±1.090)days,including migraine group from(16.57±2.521)to(1.487±1.123)days,and without migraine group from(12.52±1.122)to(1.56±1.083)days.The cumulative intensity of vertigo before and after treatment decreased from 5.67±1.167 to 2.02±0.737,including migraine group from 5.95±1.116 to 1.20±0.734,migraine group without migraine from 5.42±0.235 to 2.04±0.754),and postoperative hearing(2 ears of grade B(9.52%),C)and 6 ears of 47.62%),D(42.86%)in migraine group.In the group without migraine,there were significant differences in 5 ears of grade B(20.00%),C grade 9 ears)and 36.00%),D grade 11 ears(44.00%).There was no significant difference in vertigo control and hearing improvement between the two groupsConclusion:1.Decompression of endolymphatic sac can be used to treat some patients with vestibular migraine,which can provide a slightly innovative treatment for patients with vestibular migraine who are ineffective in conservative treatment2.Meniere’s disease and vestibular migraine may share similar pathophysiological mechanisms.3.MMD with migraine may be a special type of Meniere’s disease4.the control effect of vertigo symptoms is satisfactory in the short term,and the original hearing level is retained.