七年制医学课件 耳鼻喉 12Menieres Disease.pptVIP

Meniere’s Disease Presented By: Zhou Jianrong Ph.D. What is it? An inner ear disorder that causes one to experience periods of vertigo（眩晕）, fluctuating sensorineural hearing loss（波动性感音神经性耳聋）, tinnitus（耳鸣） and aural pressure（耳胀满感）. Endolymphatic hydrops （内淋巴水肿）in the inner ear Causes (cont) Herpes virus（疱疹病毒） (HSV) antibodies are found more commonly in Menieres patients. More recent pathologic data is supporting its viral cause. Causes (cont) About 60% of patients with?Menieres disease have serum antibodies against inner ear proteins. About 10% of Menieres patients have well documented autoimmune disorders. Some Menieres patients show evidence for a change in their immunity around the time of their attacks. Causes (cont) The inner ear Causes It is associated with a change in fluid volume in the inner ear. The membranous labyrinth（膜迷路）, which is encased by bone, is necessary for hearing and balance and is filled with a fluid called endolymph（内淋巴液）. Causes (cont) An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate, a condition known as endolymphatic hydrops. Reasonable possibilities are obstruction of endolymphatic outflow at the endolymphatic duct（内淋巴管） level, increased production of endolymph, or reduced absorption of endolymph caused by a dysfunctional endolymphatic sac（内淋巴囊）. What are the symptoms? Episodic rotational vertigo （发作性视物旋转性眩晕）(attacks of a spinning sensation) Fluctuating hearing loss（波动性听力下降） Tinnitus （耳鸣）(a roaring, buzzing, or ringing sound in the ear) Sensation of fullness（耳胀满感） in the affected ear Clinical examination The eardrum is normal The function of the eustachian tube（咽鼓管） is normal Tympanogram(鼓室图)is normal Clinical examination Nystagmus（眼震） can be seen during acute attack Audiometry（听力测验） presentation is sensorineural hearing loss Diagnosis of Meniere’s Disease Recurrent episodic rotational vertigo accompanied by nausea (lasting 20min to hours, at least 2 times), normal consciousnes