What is Meniere's Disease?

Meniere's disease is the old name of Meniere's disease, also known as Meniere's disease, which is caused by parietal labyrinth, paroxysmal vertigo, deafness and tinnitus.

Basic Information

nickname

Meniere's disease

English name

Meniere's disease

Visiting department

ENT

Common symptoms

Dizziness, deafness, tinnitus, fullness in the ears

Causes of Meniere's disease

The cause of Meniere's disease is unknown. According to the 1995 Evaluation Standard for Diagnosis and Treatment of Meniere's Disease proposed by the Hearing and Balance Committee of the American Academy of Otorhinolaryngology Head and Neck Surgery, Meniere's disease is based on the criteria for diagnosis and treatment of Meniere's disease in 1996. An idiopathic membrane with stagnant water. How the membrane membrane water is produced is unclear. The so-called "idiopathic" means that the cause is unknown or the real cause cannot be found.

There are many causes of Meniere's disease. Many patients experience work stress or excessive fatigue before onset; or have a history of anger, irritability, anxiety, or related to menstrual cycle and other factors. With the continuous progress of society, the pace of people's work and life is getting faster and faster, and the incidence of Meniere's disease has an upward trend.

Clinical manifestations of Meniere's disease

The incidence of Meniere's disease has increased year by year. It occurs mostly in developed countries and urban residents, and it rarely occurs in cold regions. More common in young adults.

Meniere's disease has four main symptoms: dizziness, deafness, tinnitus, and a feeling of fullness in the ears.

Dizziness

Most of them are sudden, severe spinal vertigo. Patients feel that themselves or surrounding objects are violently rotating in a certain direction and a certain plane, so that they must lie down with their eyes closed to prevent falls due to imbalance and reduce their fear. Some patients feel that their bodies are shaking from side to side, lifting up and down, and floating. Dizziness is accompanied by symptoms of autonomic reflexes such as nausea, vomiting, pale, cold sweats, decreased blood pressure, or even abdominal pain. Symptoms worsened when eyes were opened and turned, and relieved when eyes closed or when lying still. Patients preferred to rest with eyes closed and head fixed in a certain position. During the entire course of the onset, the patient was conscious, and even if some individuals suddenly fell, they remained awake. The duration of vertigo is relatively short, and it will relieve naturally after tens of minutes or hours, and the symptoms disappear, and it will turn into the intermittent period. In addition to the hearing period, there may be no other symptoms. The length of the rest period varies from person to person, from days to years. Dizziness often recurs. The more relapses, the longer the duration, and the shorter the interval. The degree of vertigo is more severe, but the individual varies greatly, and each attack will not be the same. The literature reports that about one-third of patients have aura symptoms during a dizzy episode. Such as dizziness, irritability, discomfort in the ears, feeling of fullness, tinnitus or changes in the nature of the original tinnitus, and low-frequency hearing loss. Patients with aura, patients with mild onset can respond protectively, sit or lie down. When the patient feels that he can't control the world, he often grasps the fixed object and keeps it, for fear that he will turn and fall in space.

Deafness

Deafness of this disease is sensorineural hearing loss. In the early stages of the disease, low-frequency hearing (125-500 Hz) usually declines, which can be fluctuating. Vertigo episodes can return to normal. Dizziness recurs, the course of the elderly, hearing impairment gradually expands, and low-frequency and high-frequency (2 to 8 kHz) hearing can be impaired and cannot be recovered. The general trend of hearing impairment is to worsen as the number of episodes increases.

There is also a very special phenomenon of hearing change, which is the phenomenon of re-listening. It is the patient's harshness when listening to high frequency and strong sound. Sometimes the affected ear and the healthy ear hear the same sound as two different sounds.

3. Tinnitus

From the beginning, it can be expressed as a continuous low-pitched whistle or running water, and a long time high-pitched cicada or sirens. Dizziness can appear or worsen before the onset of vertigo. Tinnitus disappeared during the intermittent period. People with chronic illnesses can continue to exist.

4. Ear fullness

During dizziness, some patients have a feeling of fullness, heavyness, and pressure on the affected head or ears, and sometimes feel burning or dull pain around the ears. From experience, this behavior is uncommon.

Meniere's disease test

In order to diagnose Meniere's disease correctly, the medical history is very important, and some necessary tests are also necessary.

Pure tone audiometry

The nature and extent of hearing loss and hearing loss can be found. In the early stage of typical Meniere's disease, low-frequency hearing loss is sensorineural hearing loss, and the hearing curve is rising. The longer the course of the disease, the heavier the hearing loss, and the hearing curve can be flat or falling. Pure tone audiometry can also dynamically observe the continuous changes in the patient's hearing.

2. Electronysmography

In the acute phase of Meniere's disease, obvious spontaneous nystagmus can often be observed with the naked eye, showing horizontal or horizontal rotation. The fast phase can point to the affected side or the healthy side. Because the patient is not suitable for electromyography at this time. This test should be performed routinely during the onset of seizures, often with many abnormal changes.

3. Gravity shaker check

Find out and record the situation of imbalance.

4.Glycerin test

This test is positive, indicating that there is a change in water accumulation in the labyrinth of the membrane.

5. Cochlear electrogram

It is necessary to use objective audiological examination techniques to understand whether there is stagnant water in the membrane labyrinth.

6. Auditory brainstem response

This is a method of objective observation. For patients with Meniere's disease, it is mainly to exclude post-snail lesions such as acoustic neuroma. Since the application of this test, some obsolete subjective audiometry methods, such as the loudness balance test, the short-term sensitivity index test, and the self-test audiometry, have rarely been used in clinical practice in recent years.

7. CT and magnetic resonance imaging (MRI) examination

This test should be routinely performed in patients with clinically suspected intracranial lesions.

Meniere's disease diagnosis

Because in vivo ear tissue pathology cannot be performed, the exact diagnosis of Meniere's disease is very difficult.

In 1972 and 1985, the Hearing and Balance Committee of the American Academy of Otorhinolaryngology Head and Neck Surgery published standards for reporting treatment results for Meniere's disease. This criterion is very useful for understanding Meniere's disease and its treatment. In 1995, the Commission identified several guiding principles, retained and incorporated the methods recommended in the 1972 and 1985 reports, and proposed new standards. The standard should be clearly stated, can be used directly, be as simple as possible, and have a wide range of use. It does not require special equipment, is easy to carry out statistical evaluation and comparison of research results, and can reflect the severity of the disease. The Committee considers Meniere's disease to be limited to idiopathic endolymphedema. The clinical manifestations are as follows: recurrent, spontaneous paroxysmal vertigo, hearing loss and tinnitus. The emphasis must include tinnitus, tinnitus, or both.

1. 1995 (OOAA-NHS) diagnostic criteria for Meniere's disease

(1) Establish the diagnostic criteria of Meniere's disease- limited Meniere's disease, and confirm histopathology. In fact, it is currently impossible to make a definitive diagnosis.

(2) Two or more typical spontaneous vertigo episodes of Meniere's disease , lasting 20 minutes or more; hearing loss at least once; tinnitus or tinnitus; rule out other causes.

(3) Suspected of a typical vertigo attack of Meniere's disease , hearing loss at least once; tinnitus or stuffiness; rule out other causes.

(4) Latent Meniere's disease. Meniere's disease type vertigo occurs without hearing loss; or sensorineural hearing loss, fluctuations or fixation; balance disorders but no typical attacks; exclude other causes.

The typical onset of Meniere's disease is spontaneous rotational vertigo, which lasts for at least 20 minutes, often with prolapse, impaired balance, nausea, vomiting, or retching, but unconscious loss. Horizontal or horizontal rotational nystagmus always occurs during the attack.

2. Chinese standards

It is believed that Meniere's disease is defined as an idiopathic inner ear disease, and the basic pathological change is hydrocephalus. Clinical manifestations are recurrent vertigo, sensorineural hearing loss, tinnitus and fullness. There was no dizziness between episodes. The diagnosis is based on:

(1) Recurrent vertigo occurs for 20 minutes to several hours, at least 2 times. Often accompanied by nausea, vomiting, and impaired balance. Unconscious loss. May be accompanied by horizontal or horizontal rotation type nystagmus.

(2) At least one pure tone audiometry is sensorineural hearing loss. Early low-frequency hearing declines, hearing fluctuations, and hearing loss gradually worsens as the disease progresses. A revival phenomenon may occur.

(3) Tinnitus is intermittent or persistent, and there are many changes before and after the onset of dizziness.

(4) Ear bulge may feel full.

(5) Dizziness caused by other diseases such as positional dizziness, vestibular neuritis, drug-induced vertigo, sudden deafness with vertigo, insufficient blood supply to the vertebrobasilar artery, and intracranial space-occupying lesions are excluded.

Meniere's disease treatment

1. The cause of Meniere's disease is not very clear, which brings great difficulties to clinical treatment, and it is still difficult to cure so far. Some Meniere's disease can heal itself after a few times; some patients have recurrent attacks, and vertigo can stop after hearing loss. Meniere's disease and other symptoms vary greatly, even the same The duration of each vertigo episode and the length of the interval are not the same, all of which make it difficult to estimate the efficacy of Meniere's disease.

2. Meniere's disease is a benign inner ear disease. The vast majority of patients can be relieved by conservative treatment, and not many patients need surgery.

3. Controlling salt intake is very important for treating Meniere's disease. It is generally believed that one gram of salt per person per day is more appropriate.