Meniere s Disease

Meniere s disease is a purulent disease of the inner ear characterized by an increase of both the labyrinthine fluid and inner ear pressure, thus causing bouts of progressive deafness, tinnitus, vertigo and imbalance, and autonomic disturbances (nausea, vomiting)
Meniere s disease is usually – one-way process, in 10-15% of cases – two-sided.
Meniere s disease develops without prior purulent process in the middle ear and organic diseases of the brain and its membranes. The severity and frequency of attacks may be reduced over time, but hearing loss progresses.
The predominant age of Meniere s disease is 30-50.

Classification of Meniere s disease
• The classical form of Meniere’s disease – the simultaneous violation of the auditory and vestibular function (about 30%)
• Cochlear Meniere’s disease – a disease starts with hearing disorders (50%)
• Vestibular Meniere’s disease – a disease begins with vestibular disorders (15-20% of cases).

The reasons for Meniere s disease
There are several theories that link the emergence of this disease with the reaction of the inner ear (in the form of increasing the amount of fluid and a maze of pressure within the labyrinth) to various damages
• Violations of water-salt metabolism
• Allergic diseases
• Endocrine diseases
• Vascular disease
• Viral diseases
• Syphilis
• Violation of the endolymphatic duct and endolymphatic sac
• The deformation of the valve Basta
• Obstruction of vestibular canaliculus
• Reduce the airiness of the temporal bone.
In recent years, the focus is on the theory that explains the emergence of this disease dysfunction of the nerves that innervate the blood vessels of the inner ear.


Manifestations of Meniere s disease
• fit-for (in the interictal period symptoms are usually absent, except for hearing loss).
• Gradual hearing loss, predominantly low frequency in the early stages of the disease, and sudden deterioration of periodic hearing improvement
• Dizziness – spontaneous seizures lasting from 20 minutes to several hours
Tinnitus
For severe attacks of Meniere’s disease is characterized by the following symptoms: nausea, vomiting, pallor, severe sweating, decreased body temperature, loss of the ability to maintain balance, the severity of symptoms increases with movement.

Diagnosis of Meniere s disease
Diagnosis of Meniere’s disease is the ENT doctor. Laboratory studies have focused on the exclusion of other diseases with similar symptoms.
• Specific serological tests for Treponema pallidum
• A study of the thyroid gland
• Study of lipid metabolism.
• Otoscopes
• the study of hearing
• Investigation of the vestibular apparatus
• Visualization – magnetic resonant imaging to exclude acoustic neuroma.

Treatment of Meniere s disease:
• Usually with Meniere’s disease shows outpatient treatment. The attack can be cut short outpatient. If necessary, surgery patients hospitalized
• Physical activity is limited during the attacks. Recommended a full physical activity in the interictal period
• Diet in the treatment of Meniere’s disease: restriction of food intake during bouts of nausea. In some cases it is advisable to limit the consumption of salt. Diet is not considered to be factors that provoke attacks
• Patients with Meniere’s disease do not have to work in extreme conditions (underground, underwater or high-altitude works), in an area of high risk of injury (for moving parts), and service all types of vehicles
• especially in patients with Meniere’s disease – severe emotional lability, so they need more attention
• It is important to carry out periodic review hearing in connection with progressive deterioration.


The prognosis of Meniere’s disease
In most cases, conservative treatment of Meniere’s disease is effective, but in 5-10% of cases need surgical treatment for vertigo.

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