内耳置管治疗突聋、耳鸣和梅尼埃

内耳疾病，比如突发性耳聋、梅尼埃病(美尼尔)、耳鸣和免疫性耳聋，其治疗的难点就是药物很难从血液里直达内耳。即便是通过鼓膜穿刺注射药物进入中耳腔，也难以确保药物能够进入内耳。美 国 医 生 Herbert Silverstein 在20年前就发明了通过鼓膜置管经过中耳，再通过圆窗进入中耳。

THIS NEW TECHNIQUE developed by Dr. Herbert Silverstein was designed to deliver medication to the inner ear using a Micro Wick™.The first drug used was dilute gentamicin, an antibiotic solution that the patient places in their ear three times a day for two to three weeks. This method is similar to treating eye diseases with eye drops. Thus far the results have been excellent in relieving vertigo attacks in 80% of the patients and preserving hearing in most patients. In 60% of patients, the pressure and tinnitus have been reduced.

Dexamethasone is used to treat certain cases of Meniere's disease where the complaints are mostly hearing loss, pressure and tinnitus in the ear. The MicroWick™ has also been used to deliver steroids directly to the inner ear thus avoiding subjecting the body to the side effects of steroids. The results are excellent and work best early in the disease when there is little damage to th e inner ear from the disease.

This minimally invasive office procedure is done using local anesthesia. The ESC Lumenis CO2 laser is used to create a bloodless opening in the eardrum through which a tiny endoscope is inserted. Any obstructing membranes near the round window membrane are easily removed with an instrument before the MicroWick™ is inserted. Next, a tiny tube is placed in the tympanosto my opening. Now the round window membrane is clearly seen and the Silverstein Inner Ear MicroWick™ is inserted. This allows the medication to reach the round window membrane and diffuse into the inner ear fluids, which willtreat the inner ear disease.

The treatment is far less expensive than hospitalization for surgery. lt is also painless and well tolerated by patients. Most insurances cover the procedure. After the treatment. the tube and the MicroWick™ are easily removed in the office. The opening in the eardrum heals rapidly. There have been few complications and excellent results.