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Meniere’s disease
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Meniere’s disease

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  • 1.  In 1861 Prosper Meniere described a syndrome characterized by deafness, tinnitus, and episodic vertigo. He linked this condition to a disorder of the inner ear.
  • 2.  It is a syndrome characterized by a tried of symptoms; attacks of incapacitating vertigo, Sensorineural hearing loss & Tinnitus.
  • 3.  It is usually occur in adulthood.
  • 4. Etiology:-  Unknown Risk factor:-  Metabolic disorder  Toxicity  Allergies  Emotional factor  Circulatory disorder  Anatomical abnormalities
  • 5. Dilated membranous labyrinth in Meniere's disease (Hydrops)
  • 6. Due to etiological factors Over production of endolymph Excessive accumulation in inner ear Increase pressure Rupture of membrane Permanent loss auditory & vestibular function
  • 7.  Periodic episodes vertigo or dizziness  Tinnitus  Sensorineural Hearing loss  Fullness/pressure  Nausea, vomiting, Diarrhea  Increase pulse rate  Diaphoresis  Disorientation
  • 8.  History Pattern of symptoms Association between hearing loss, tinnitus, and vertigo  Physical examination  Otoscopic examination
  • 9.  Rinne (usually indicates that air conduction remains better than bone conduction) & weber test(Assess the bone conduction of sound with Tuning fork)  Audiometric examination  Electronystogmography(ENG)  Audiometric brain stream response
  • 10.  Goal To Control vertigo Preserve hearing Stabilize tinnitus Nonpharmacological management:- a. Low sodium diet b. Labyrinthine compensatory exercise c. Avoidance of caffeine, nicotine & alcohal
  • 11.  Vestibular suppressants (eg, meclizine)  Diuretics (eg, hydrochlorothiazide) actually decrease the fluid pressure load in the inner ear.  Vasodilator  Anticholinergic  Antiemetic eg. Trimethobenzamide 250 mg TDS  Anti-inflammatory (steroids)
  • 12.  Ototoxic ablation therapy ( Transtympanic injection of antibiotics that are toxic to inner ear)  Endolymhatic decompression  Labyrinthectomy
  • 13.  Partial or total loss of hearing.  Constant tinnitus  Permanent balance disability  Fear, phobia  Dehydration  Decrease quality of life  Trauma from falling
  • 14.  Risk for fluid volume deficit R/T increase fluid output, altered intake.  Risk for injury R/T altered mobility & vertigo.  Altered auditory sensory perception R/T altered state of the ear.  Anxiety R/t threat to changes health status.  Body image disturb R/T vertigo.