Meniere's Disease - purulent inner ear disease characterized by an increase in volume and increasing fluid maze vnutrilabirintnogo pressure in thus creating bouts of progressive deafness, tinnitus, vertigo and imbalance, and autonomic disturbances (nausea, vomiting)
Typically, Meniere's disease - a one-way process, in 10-15% of cases - sided.
The disease develops without prior purulent process in the middle ear and organic diseases of the brain and its meninges. The severity and frequency of attacks may decrease with time, however, a hearing impairment progresses.
The predominant age of Meniere's disease - 30-50 years.
Classification
- The classical form of Meniere's disease - simultaneous violation auditory and vestibular function (approximately 30% occurrence)
- Cochlear form - Disease starts with hearing disorders (50%)
- Vestibular form - disease begins with vestibular disorders (15-20% of cases).
Causes
There are several theories relating the occurrence of this disease with the response of the inner ear (in a larger amount of labyrinthine fluid and increase the pressure within the labyrinth) at various injury
- Violations of water-salt metabolism
- allergic diseases
- endocrine diseases
- vascular disease
- viral diseases
- Syphilis
- Impaired function of the endolymphatic duct and the endolymphatic sac
- Deformation Basta valve
- Blockage of the vestibular aqueduct
- Reducing the airiness of the temporal bone.
In recent years, the focus is on the theory that explains the occurrence of this disease in violation nerve function, innervate the blood vessels of the inner ear.
The symptoms of Meniere's disease
- Paroxysmal flow (in the interictal period disease signs are usually absent, except for hearing loss).
- Progressive hearing loss, predominantly low frequency in the early stages of the disease; periodic and sudden deterioration improve hearing
- Dizziness - spontaneous episodes lasting from 20 minutes to several hours
- Noise in ears
For severe attacks of Meniere's disease is characterized by the following symptoms: nausea and vomiting, paleness, expressed sweating, decreased body temperature, loss of the ability to maintain balance, severity of manifestations is enhanced by movement.
Diagnostics
Diagnosis is made ENT doctor. Laboratory studies have focused on the exclusion of other diseases with similar symptoms.
- Specific serological tests for the detection of Treponema pallidum
- Investigation of the thyroid gland
- The study of indicators of fat metabolism.
- otoscopy
- hearing Investigation
- A study of the vestibular apparatus
- Visualization - rezonanskaya magnetic imaging to rule out acoustic neuroma.
Treatment of Meniere's disease
Usually it is shown in Meniere's disease patient treatment. The attack is possible to stop an outpatient basis. If necessary, surgery the patient is hospitalized
Physical activity is limited during attacks. Recommended full physical activity in the interictal period
Diet in the treatment of Meniere's disease: limiting food intake during nausea. In some cases, it is advisable to limit the intake of salt. Diets do not belong to, provoke attacks factors
Patients with Meniere's disease do not have to work in extreme conditions (underground, underwater or high-rise papers) in the zone of increased risk of accidents (in moving mechanisms), serving all types of traffic means
Feature of patients with Meniere's disease - severe emotional lability, so they need more attention
It is imperative to conduct a periodic review of the hearing due to his progressive deterioration
Drugs of choice for attack (one of the drugs):
- atropine,
- diazepam,
- scopolamine.
In the interictal period:
- meklozin 25-100 mg orally at bedtime or in divided doses,
- phenobarbital or diazepam,
- dimenhydrinate,
- promethazine,
- diphenhydramine,
- hydrochlorothiazide with potassium preparations,
- dimephosphon.
Forecast
In most cases, conservative therapy Meniere's disease is effective, but 5-10% of the cases the surgical treatment is necessary in connection with vertigo.
