Meniere’s disease

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Meniere’s disease

  1. 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. 2.  It is a syndrome characterized by a tried of symptoms; attacks of incapacitating vertigo, Sensorineural hearing loss & Tinnitus.
  3. 3.  It is usually occur in adulthood.
  4. 4. Etiology:-  Unknown Risk factor:-  Metabolic disorder  Toxicity  Allergies  Emotional factor  Circulatory disorder  Anatomical abnormalities
  5. 5. Dilated membranous labyrinth in Meniere's disease (Hydrops)
  6. 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. 7.  Periodic episodes vertigo or dizziness  Tinnitus  Sensorineural Hearing loss  Fullness/pressure  Nausea, vomiting, Diarrhea  Increase pulse rate  Diaphoresis  Disorientation
  8. 8.  History Pattern of symptoms Association between hearing loss, tinnitus, and vertigo  Physical examination  Otoscopic examination
  9. 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. 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. 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. 12.  Ototoxic ablation therapy ( Transtympanic injection of antibiotics that are toxic to inner ear)  Endolymhatic decompression  Labyrinthectomy
  13. 13.  Partial or total loss of hearing.  Constant tinnitus  Permanent balance disability  Fear, phobia  Dehydration  Decrease quality of life  Trauma from falling
  14. 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.

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