Meniere’D Disease

– an abnormal inner ear fluid balance caused by a malabsorption in the endolyphatic sac or blockage in the endolyphatic duct.
– chronic disease caused by an increase in endolymphatic pressure High in males (40-60 years old)
Unknown Etiology
Clinical Manifestations:
* fluctuating, progressive sensorineural hearing loss
* tinnitus or a roaring sound
* feeling of pressure or fullness in the ear
* episodic, incapaciating vertigo (severe dizziness)
* nausea and vomiting

Pathophysiology
The endolymph and perilymph (ie, fluids that fill the chambers of the inner ear) are separated by thin membranes that house the neural apparatus of hearing and balance. Fluctuations in pressure stress these nerve-rich membranes, causing hearing disturbance, tinnitus, vertigo, imbalance, and a pressure sensation in the ear. Attacks of hydrops probably are caused by an increase in endolymphatic pressure, which, in turn, causes a break in the membrane that separates the perilymph (potassium-poor extracellular fluid) from the endolymph (potassium-rich intracellular fluid).

The resultant chemical mixture bathes the vestibular nerve receptors, leading to a depolarization blockade and transient loss of function. The sudden change in the rate of vestibular nerve firing creates an acute vestibular imbalance (ie, vertigo). The physical distention caused by increased endolymphatic pressure also leads to a mechanical disturbance of the auditory and otolithic organs.

Because the utricle and saccule are responsible for linear and translational motion detection (as opposed to angular and rotational acceleration), irritation of these organs may produce nonrotational vestibular symptoms. This physical distention causes mechanical disturbance of the organ of Corti as well. Distortion of the basilar membrane and the inner and outer hair cells may cause hearing loss and/or tinnitus.

Since the apex of the cochlea is wound much tighter than the base, the apex is more sensitive to pressure changes than the base. This explains why hydrops preferentially affects low frequencies (at the apex) as opposed to high frequencies (at the relatively wider base). Symptoms improve after the membrane is repaired as sodium and potassium concentrations revert to normal. Various extrinsic mechanisms are thought to contribute to the development of endolymphatic hydrops, including infection, trauma, and allergens.

Management

Bed rest
Diet: Low salt or Sodium

Pharmacologic Therapy
Antihistamines
* Meclizine (Antivert)-suppresses the vestibular system
Tranquilizers
* Diazepam (Valium)-may be used in acute instances to help control vertigo. Antiemetics
* Promethazine (Phenergan)-suppositories help control the nausea and vomiting and the vertigo because of their antihistamine effect. Diuretic therapy
* (hydrochlorothiazine (diazide), triamterene (dyrenium)) -may relieve symptoms by lowering the pressure in the endolymphatic system.

Surgical Management
Endolymphatic sac decompression or shunting
-theoretically equalizes the pressure in the endolymphatic space.
-a shunt or drain is inserted in the endolymphatic sac through a postauricular incision. Vestibular Nerve Sectioning
-cutting the nerve and prevents the brain from receiving input from the semicircular canal Labyrinthectomy
– surgical removal of the membranous labyrinth through the oval window or through the mastoid bone

MENIERE’S DISEASE

Submitted by:
Baldonado, Nicasio Jr. J.

Submitted to:
Mrs. Patalinghug.

The endolymph and perilymph (ie, fluids that fill the chambers of the inner ear) are separated by thin membranes that house the neural apparatus of hearing and balance. Fluctuations in pressure stress these nerve-rich membranes, causing hearing disturbance, tinnitus, vertigo, …

Anatomically, an ear is a vertebrate organ of hearing and is responsible for sensing and collecting sounds as well as maintaining equilibrium. The ear is divided into three sections, the outer ear (pinna), the middle ear, and the inner ear. …

In 1861, the French physician Prosper Meniere described a condition which now bears his name. Meniere’s disease is a disorder of the inner ear which causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure …

Meniere’s Disease is common, occurring in more than 3-5 million Americans. Meniere’s Disease is a condition characterized by recurrent vertigo (dizziness), hearing loss, and tinnitus ( a roaring, buzzing, or ringing sound in the ears). These affects only occur in …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy