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フクシマ ムネヒサ
Fukushima Munehisa
福嶋 宗久 所属 医学部 医学科（附属足立医療センター） 職種 講師 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Assessment of the Progression of Vertical Semicircular Canal Dysfunction and Increased Vestibular Endolymphatic Hydrops in Patients With Early-Stage Ménière Disease. |
| 掲載誌名 | 正式名：JAMA otolaryngology-- head & neck surgery 略 称：JAMA Otolaryngol Head Neck Surg ISSNコード：2168619X/21686181 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 146(9),pp.789-800 |
| 著者・共著者 | Fukushima Munehisa†*, Ueno Yuya, Kitayama Itsuki, Akahani Shiro, Inohara Hidenori, Takeda Noriaki |
| 担当区分 | 筆頭著者,責任著者 |
| 発行年月 | 2020/09 |
| 概要 | IMPORTANCE:Vertical semicircular canals and endolymphatic hydrops play important roles in the pathophysiological mechanisms of Ménière disease. However, their characteristics and associations with disease progression during medical treatment have not been determined.OBJECTIVE:To examine the function of both the horizontal and vertical semicircular canals in patients with Ménière disease and to evaluate the change in endolymphatic hydrops volume during medical treatment, including treatment with diuretic therapy, over a 2-year period.DESIGN, SETTING, AND PARTICIPANTS:This prospective longitudinal observational cohort study included 55 patients with definite unilateral Ménière disease and was performed in a tertiary care hospital in Japan. Participants were enrolled between April 1, 2017, and January 31, 2018, and those with vestibular migraine were excluded. All participants received education regarding diet and lifestyle modifications and treatment with betahistine mesylate (36 mg daily) and/or an osmotic diuretic (42-63 mg daily). Patients were followed up for vertigo and hearing evaluations at least once per month for more than 12 months and were instructed to record episodes of vertigo in a self-check diary. Audiometry was performed monthly, video head impulse testing and caloric testing were performed every 4 months, and magnetic resonance imaging was conducted annually. Data were analyzed from May 15, 2017, to January 31, 2020.MAIN OUTCOMES AND MEASURES:Neurootological testing to evaluate vestibuloocular reflex gain over time, magnetic resonance imaging to evaluate the change in endolymphatic hydrops volume over time, and monthly vertigo and hearing evaluations for more than 12 months.RESULTS:Among 55 participants with definite Ménière disease, 32 patients (58.2%) were female, and the mean (SD) age was 59.0 (15.1) years. The median disease duration was 2 years (interquartile range, 0-4 years), with 43 patients (78.2%) having an early stage (ie, disease duration |
| DOI | 10.1001/jamaoto.2020.1496 |
| PMID | 32644132 |