Synonyms
Menièr’s disease
Definition
Meniere’s disease is a complex disease of the acoustic system of the human body, which consists of three different symptoms and can affect the patient in different ways. Treatment of Menière’s disease should be carried out quickly, if possible at the first appearance of the symptom complex, in order to avoid a complete manifestation of the disease. Although the exact cause of the disease is still unknown, the pathomechanism of the disease is largely clear and can be treated symptomatically.
First and foremost, there are a number of drugs that are intended primarily to relieve pressure in the inner ear: A great deal of research is currently being done in the field of drug treatment of Meniere’s disease, and some promising results of studies with new drugs remain to be seen.
- Drainage drugs (diuretics).
- Dizziness reducing drugs (antiemetics) Betahistin®
In addition to drug treatment, there are several other causes and consequences of the disease that need to be clarified and treated:
- Orthopedic problems (postural problems of the cervical spine)
- Chronic malocclusion (malpositioning of the temporomandibular joint) a significantly higher risk of recurrence of Meniere’s disease than other patients. For this reason, malocclusions should be corrected by dentists and postural defects should be orthopedically compensated.
This should round off the therapy of Meniere’s disease and reduce the frequency of attacks.
- Psychological stress (anxiety disorders, overcautiousness) In this case, accompanying psychological care of the patient should be considered. At least as long as the complaints are of a massive nature, anxiety training and psychological counselling should be carried out. In the course of time, depending on the frequency of the seizures and the severity of the illness, the therapy can be reduced or finally stopped completely.
In addition to drug therapy and psychotherapeutic treatment methods, there are numerous complementary surgical and alternative forms of treatment with varying degrees of success.
1) Surgically, the eardrum can cause a so-called This means that patients initially suffer from severe seizure-like dizziness attacks in the period after the operation, which then have to be trained. If this is successful, the patients have a good chance of leading a life free of complaints. Nowadays, the cutting of the nerve is rarely performed.
A pressure device that can be inserted into the ear and exerts different pressures via the middle ear into the inner ear can also be used to try to treat the disease.
- Timpani tubes are inserted, which ensures a direct connection between the middle and outer ear. This surgical treatment is very successful in many patients for whom drug treatment has not helped, and the patients may be permanently free of symptoms.
Another advantage of a tympani tube is that, if necessary, medication can be administered directly into the middle ear, which can then travel to the inner ear. A timpani tube can remain in the ear for a long time, but the correct position should be checked from time to time by an ENT specialist.
- Another surgical treatment method for the disease is labyrinthine anaesthesia. In this procedure, access to the middle ear is made through a small incision in the eardrum.
An anesthetic is injected into the middle ear through this incision. This anaesthetic then moves into the labyrinth system and can thus reduce and calm the metabolic processes. The treatment method is still relatively new, but initial results show that it seems to work.
The anesthesia can cause a short but severe dizziness before the positive effects of the treatment method take effect.
- Tenotomy: here also the opened eardrum cuts through the muscles of the middle ear. This probably leads to a general reduction in pressure and thus to a reduction in symptoms. The results of this treatment are very positive.
The organ of equilibrium contains fluid, the pressure of which rises sharply in Menièr’s disease. The fluid is stored in a bony space in the base of the skull and cannot expand when needed.
- In surgical saccotomy, an access is placed behind the ear to this reservoir and the bony wall is opened.This leads to a better distribution of the pressure of the liquid.
- Surgical cutting of the vestibular nerve if all treatment methods are unsuccessful. This procedure is more complicated and has to be considered carefully, as it can lead to severe side effects after the surgical cut. In some cases, facial nerve injuries may occur. Furthermore, the cutting of the vestibular nerve is accompanied by an irreversible failure of the vestibular organ on one side.
For further information on this topic, please visit Related topics that might be of interest: You will find all topics that have been published in the field of ENT under: Related Topics
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