Meniere’s disease is an idiopathic inner ear disease with symptoms such as vertigo, deafness, tinnitus and a feeling of stuffiness in the ear. The cause is unknown, and there is no significant difference in the incidence between men and women. There are many theories about the cause of the disease, but there is no definite conclusion yet, such as autonomic dysfunction caused by metabolic reactions, endocrine disorders, vitamin deficiencies and psychoneurological factors, which cause vascular nerve dysfunction and increase capillary permeability, resulting in fluid accumulation in the membranous vagus and expansion of the cochlea and balloon, causing a series of clinical symptoms such as tinnitus, deafness and vertigo when the cochlea and vestibular receptors are stimulated. Without treatment, the symptoms can be relieved or recurring, with variable intervals between attacks, but there are cases where one attack never occurs again. The clinical manifestations are recurrent vertigo, sensorineural deafness, tinnitus, and a feeling of fullness in the ear. First-episode Ménière’s disease usually presents with low-frequency tinnitus and hearing loss, accompanied by a feeling of stuffiness or pressure in the affected ear. The duration of vertigo in Ménière’s disease is usually tens of minutes to twenty-four hours.
What is the diagnosis of Ménière’s disease based on?
History is the most important in the diagnosis of Ménière’s disease. Ancillary tests such as pure tone audiometry, cochlea electrogram, cold and heat test, VEMP, and glycerol test are valuable in the diagnosis of Ménière’s disease, among which glycerol test is the most valuable and is the gold standard for the diagnosis of Ménière’s disease.
What tests should be done for Ménière’s disease?
In acute attacks, the patient is seen to be bedridden, pale, nervous and with a fearful expression. Examination reveals.
1, Nystagmus episodes culminating in spontaneous nystagmus are seen.
2. Audiological examination includes: pure tone hearing threshold test, acoustic conduction resistance test, cochlear electrogram test.
3, glycerol test, the patient is asked to take glycerol reagent orally and measured every hour to check the pure tone audiometry, three times in a row, this is the use of glycerol dehydration properties of temporary reduction of membrane vagal fluid, if the hearing after taking the drug is improved, the existence of membrane vagal fluid is confirmed.
4, vestibular function examination: cold and heat test is the main test, most patients examined have one side of the horizontal semicircular canal function is reduced.
How to treat Ménière’s disease effectively?
1.General treatment
During an attack, the patient should lie still, refrain from anxiety, enter a light and low-salt diet, limit the amount of water intake, and avoid using tobacco, alcohol and coffee. During the interval, encourage the patient to exercise, strengthen the body and pay attention to the combination of work and rest.
2.Medication
The principle of treatment during the attack is to alleviate the symptoms of vagal effusion, available 20% mannitol 250ml rapid intravenous drip, twice a day, the recent clinical effect is relatively obvious; for severe vomiting, vertigo, palpitations can be given sedation, antiemetic treatment.
(1) Keep quiet and lie still.
(2) Symptomatic treatment with sedative drugs: such as Valium, lidocaine, etc., can be combined with the use of fenagan.
(3) Apply diuretics: hydrochlorothiazide, aminoglutethimide.
(4) Use vasodilators as appropriate: flunarizine, betahistine mesylate tablets, etc.
(5) Surgical treatment
Surgery is only applicable to patients with severe hearing loss and ineffective drug therapy. It is limited to patients with unilateral disease. According to statistics, only 5% of patients with Ménière’s disease require surgery. Surgery is summarized in 3 types: destructive, semi-destructive, and conservative.
Surgical treatment includes: endolymphatic bursa decompression, balloon fistula, vagotomy, and vestibular nerve dissection. Most patients in general do not undergo destructive and semi-destructive surgery.
(6) Meniett treatment
Meniett low-pressure pulse therapy device mainly uses low-pressure pulse pressure waves to conduct to the inner ear membrane vagus to improve the circulation of endolymph and reduce the water accumulation in the inner ear membrane vagus so as to achieve the therapeutic effect. The device is simple to use, and patients can treat themselves at any time and place; it is non-invasive, complication-free, safe and effective, and does not require additional rehabilitation and medication after treatment.
What are the precautions for patients with Meniere’s disease in the seizure phase?
1, diet: these patients’ membrane vagus is mostly in a waterlogged state, endolymph physicochemical characteristics are mostly high sodium and low potassium, therefore, in the diet should be selected “two high and two low” characteristics of the diet, that is, high protein, high vitamin, low fat, low salt diet, such as lean meat, fresh fish, live poultry and other stews frequently, but also more fruits, leeks, carrots, celery and other high vitamin diet. Carrots, celery and other high vitamin vegetables and fruits.
2, life and living: pay attention to the seizure period should be bed rest, the room light to a slightly darker appropriate, to avoid the environment noisy and noisy, should be quiet rest. After the symptoms have subsided, it is advisable to gradually get out of bed and avoid long-term bed rest.
3. For those who have been ill for a long time, have frequent seizures and suffer from neurasthenia, explain the condition to the patient and relieve their mental tension and fear. Pay attention to the regularity of life, prohibit tobacco, alcohol, coffee and other stimulating products.
4.After the attack period, the symptoms are relieved, and those who were engaged in driving, gymnastics, dancing, etc. should not rush to resume their original work and training. However, you should always take vestibular depressant drugs such as Valium and vertigo stop to prevent sudden attacks of vertigo.