(Disclaimer: This article is for scientific use only, and the information in the following content has been processed to protect patient privacy)
Abstract: Meniere’s disease is a type of vertigo disorder. The cause of this disease is unknown, and the diagnosis can be clearly made by clinical manifestations plus audiological examination, and patients suffering from this disease often present with recurrent episodes of vertigo and vomiting. In this case, the patient was diagnosed with Meniere’s disease of the left ear through positive examination and past medical history. Through active surgery and medication, the patient’s vertigo attacks were controlled, tinnitus symptoms were significantly reduced, and hearing was improved, and she was finally discharged successfully.
Basic information】Female, 51 years old
Disease Type】Ménière’s disease (left)
Hospital】Qilu Hospital of Shandong University
Date of Consultation】January 2022
Treatment plan】Surgical treatment (left ear tympanic membrane puncture + tympanic chamber dexamethasone injection) + medication (blood sparing injection, injectable hepaticoside sodium, betahistine mesylate tablets, duloxetine hydrochloride enteric solution tablets, and comfort capsule)
Treatment period】7 days of inpatient treatment, 4 months of outpatient follow-up
Effect of treatment] The vertigo attack of Meniere’s disease was controlled, tinnitus was reduced, and hearing was improved.
I. Initial consultation
A patient had recurrent episodes of vertigo with no obvious cause 2 years ago, accompanied by a feeling of spinning, nausea and vomiting, each lasting 2-3 hours, with left tinnitus, dullness and hearing loss. In the past 1 month, the patient found that the frequency of vertigo attacks increased after mood swings, with an average of 2 attacks per week. At the time of consultation, the patient was worried about vertigo attacks, so he was in poor spirits. He reported that he had constant tinnitus in his left ear, which affected his sleep and made him feel upset. After pure tone audiometry, the results showed that the patient had severe sensorineural deafness in the left ear and mild high-frequency neural deafness in the right. The patient was considered to have left-ear Ménière’s disease, based on her past medical history and examination results.
II. Treatment history
Since the disease is not well known to the general public in daily life, we explained to the patient about Ménière’s disease and made him aware of the natural course of the disease. At the same time, we educated the patient about lifestyle modification, choosing a low-salt diet, prohibiting smoking, alcohol, tea, coffee, chocolate, MSG, etc., and avoiding contact with allergens, so as to ensure sleep, relaxation, and daily attention to work and rest. After the patient’s consent was obtained, the patient underwent left ear tympanocentesis + tympanic chamber dexamethasone injection, and was given medication by intravenous and oral means, including blood sparing injection, sodium hepaticoside for injection, betahistine mesylate tablets, followed by vestibular rehabilitation. For the patient’s anxiety and sleep disorder, Duloxetine Hydrochloride Enteric Dissolve Tablets and Comfort Sleep Capsules were given for treatment.
III. Treatment effect
After a series of comprehensive treatment, the patient’s symptoms were significantly improved after 7 days of hospitalization, and the patient was discharged from the hospital for rest and recuperation. Four months after discharge, the patient was informed that the treatment effect was good, and there was no vertigo attack at present, and the patient felt that the symptoms of tinnitus in the left ear were significantly reduced, the hearing was slightly improved, and there were no obvious symptoms of dullness in the ear, and the mood was improved, and there was no distraction, and the quality of diet and sleep was acceptable, and the disease did not affect the daily work life.
IV. Notes
I am glad that after a series of treatments, the patient’s tinnitus symptoms have improved significantly and his mood has been relieved. The disease no longer affects normal work and life, but the patient still needs to pay attention to the following points.
1. After being discharged from the hospital, patients should continue to take oral medication for 3-6 months and have regular follow-ups in order to adjust their medication; patients should actively observe their condition after discharge and seek medical attention once they experience frequent episodes of vertigo or are accompanied by other neurological symptoms, including hoarseness, choking on water, sensory and motor disorders, etc.
2. Patients should pay attention to adjust their lifestyles in daily life, to have a low-salt diet, to avoid stimulants such as tobacco, alcohol, tea, coffee, chocolate, MSG, allergic foods and drugs, to ensure sleep, to relax, to pay attention to work and rest, to live a regular life, and to avoid being in a noisy environment in daily life as much as possible.
V. Personal insight
Meniere’s disease is a common type of otogenic vertigo, and the patient in this case had many episodes of vertigo, which led to anxiety and depression, which in turn triggered vertigo episodes, thus forming a vicious circle. Therefore, for the treatment of Meniere’s disease, a comprehensive and integrated treatment, especially the control of various triggering factors, can significantly reduce the frequency of vertigo attacks. At the same time, it is important to educate patients about the correct knowledge of the disease and to pay attention to the adjustment of daily life and emotional management, as well as to pay more attention to diet, which is essential for the control of vertigo attacks.