تعريف

Meniere’s disease is a disorder of the labyrinth in the inner ear. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.

56

أسباب

An increase in the volume or pressure of fluid in the labyrinth can result in Meniere’s disease. The cause of these fluid changes is unknown. Possible causes may include:

  • Part of the labyrinth ruptures, allowing fluid in different compartments to mix
  • Scar tissue causes a blockage in the labyrinth
  • Inner ear injury due to:
    • عدوى فيروسية
    • Syphilis, a sexually-transmitted disease
    • اضطرابات المناعة الذاتية
    • مشاكل في الأوعية الدموية
    • High cholesterol or other fats in the blood
    • Hormonal disorders
    • Medications, such as antibiotics and chemotherapy agents

عوامل الخطر

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for Meniere’s disease include:

  • Age: 20 to 60
  • العرق: قوقازي
  • Family history of Meniere’s disease
  • ضغط
  • الحساسية
  • Excess salt in the diet
  • Excess noise

الأعراض

The intensity of symptoms can vary from one person to another. Symptoms usually come on suddenly. They typically involve only one ear, but may involve both.

قد تشمل الأعراض ما يلي:

  • Episodes of vertigo (spinning sensation), often accompanied by:
    • الغثيان أو القيء
    • التعرق
    • Paleness of the skin
    • Weakness or falling
    • In some cases, headache or diarrhea
  • Hearing loss may worsen during attacks of vertigo
  • طنين الأذن (طنين في الأذنين)
  • Feeling of fullness or pressure in the ear
  • Poor sense of balance
  • A tendency for symptoms to worsen with movement

التشخيص

The doctor will ask about your symptoms and medical history, and perform a physical exam. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.

قد تشمل الاختبارات ما يلي:

  • Blood tests—to check for an underlying cause
  • Hearing test —this is also called an audiometry
  • Electronystagmogram—a type of eye movement test
  • Auditory brainstem response—measures electrical activity in the hearing nerve and brain stem
  • Electrocochleogram—measures electrical response of the inner ear to sound
  • MRI scan —a test that uses magnetic waves to make pictures of structures inside the ear

العلاج

قد يشمل العلاج ما يلي:

التغييرات الغذائية ونمط الحياة

These may help limit symptoms:

  • Bed-rest during acute attacks of vertigo
  • Avoid foods that are high in salt and high in sugar
  • Drink adequate fluids
  • Promptly begin replacing fluids lost to heat or exercise
  • Avoid caffeine, aspirin, and smoking
  • Minimize stress
  • Avoid medications that seem to bring on or worsen symptoms
  • Consider a hearing aid, if necessary
  • Consider masking devices (white noise) to limit the effects of tinnitus
  • Take safety measures to avoid falling
  • Restrict chocolate consumption
  • Reduce alcohol intake

Vestibular Exercises (Vestibular Rehabilitation)

قد يقترح طبيبك تمارين دهليزية محددة. تستخدم هذه التمارين سلسلة من حركات العين والرأس والجسم لتعويد الجسم على الحركة دون دوخة. يمكنك العمل مع معالج فيزيائي لتعلم هذه الأمور.

الأدوية

تشمل الأدوية:

  • Drugs to treat vertigo, such as meclizine or scopolamine
  • Antiemetics—medications to help control nausea
  • Other medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
    • Antihistamines
    • Cortisone drugs for a short time
    • Antidepressants or anti-anxiety medications
    • Diuretics
  • Aminoglycoside therapy (such as streptomycin or gentamicin) to permanently destroy the part of the inner ear that deals with balance

جراحة

Surgical procedures are not always helpful, and include:

  • Endolymphatic sac decompression—removal of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluid
  • Labyrinthectomy—destruction or removal of the entire inner ear, which controls balance and hearing
  • Vestibular nerve section

الوقاية

There are no specific guidelines for preventing Meniere’s disease. However, to help reduce your risk, avoid the following risk factors:

  • High-salt diet
  • High-sugar diet
  • Excess noise
  • Excess alcohol
  • ضغط
  • التدخين
  • Use of drugs that can be toxic to the ear such aminoglycosides, aspirin, and quinine
انتقل إلى أعلى