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目的:分析飞行人员梅尼埃病的临床特点,总结其航空医学鉴定原则。方法:收集1966-2011年因梅尼埃病住院的35例飞行人员的临床资料,分析其临床特点、诊疗经过及航空医学鉴定情况。结果:35例患者主诉症状中,34例有眩晕,27例有耳鸣,21例有听力下降。①累及耳蜗及前庭,主要症状表现为梅尼埃病典型三联征或四联征者18例;②症状表现为眩晕、耳鸣,未主诉明显听力下降者7例(其中4例经检查有低频听力下降);③仅累及前庭,表现为眩晕者7例;④仅累及耳蜗,表现为耳鸣、听力下降者2例;表现为听力下降者1例。根据美国听力与平衡委员会诊断标准,限定性梅尼埃病22例,可能性梅尼埃病2例,潜在性梅尼埃病11例。限定性梅尼埃病及可能性梅尼埃病患者分期为:一期11例,二期7例,三期6例,无四期患者。35例患者均给予飞行不合格结论。症状首次发作到停飞的时间为3个月～11年。结论:飞行人员梅尼埃病的诊断要慎重,对于不典型梅尼埃病患者,需要在完全排除其他可能疾病的情况下做出诊断。一旦确诊,通常应做飞行不合格结论,未来特许放飞标准有待进一步探讨。
OBJECTIVE: To analyze the clinical features of Meniere’s disease in pilots and to summarize their principles of aeromedical identification. Methods: The clinical data of 35 pilots hospitalized with Meniere’s disease from 1966 to 2011 were collected to analyze the clinical features, diagnosis and treatment, and aviation medical identification. Results: Of the 35 patients complained of symptoms, 34 had dizziness, 27 had tinnitus, and 21 had hearing loss. ① involving the cochlea and vestibule, the main symptoms of Meniere’s disease characterized by typical triad or quadruplex in 18 cases; ② symptoms were vertigo, tinnitus, no complaints of significant hearing loss in 7 cases (4 cases were examined by low-frequency hearing Decreased); ③ only involving the vestibule, manifested as vertigo in 7 cases; ④ only involving the cochlea, tinnitus, hearing loss in 2 cases; performance of hearing loss in 1 case. According to the American Hearing and Balance Commission diagnostic criteria, 22 cases of defined Meniere’s disease, the possibility of Meniere’s disease in 2 cases, 11 cases of potential Meniere’s disease. Limited Meniere’s Disease and Possibilities Meniere’s disease is staged in 11 patients in stage 1, 7 in stage 2 and 6 in stage 3, with no stage IV disease. 35 patients were given flight failure conclusion. Symptoms for the first attack to grounded time is 3 months to 11 years. Conclusions: The diagnosis of Meniere’s disease in pilots should be considered with caution. Patients with atypical Meniere’s disease need to be diagnosed with complete exclusion of other possible diseases. Once diagnosed, usually should do the flight failed conclusion, the future license release standards to be further explored.