梅尼埃病病因学研究进展

梅尼埃病的病因至今尚无定论,近年来人们在梅尼埃病的病因学方面有了更深入的研究。本文就影像学、病理生理、病毒感染、免疫等方面的最新研究进展进行了综述。     

梅尼埃病的治疗研究进展

梅尼埃病的治疗要遵循循证医学,包括药物治疗;6月后仍有眩晕症状者,可采用鼓室内注射地塞米松;3月后仍无效者,鼓室内注射庆大霉素适用于深度聋患者,内淋巴囊减压术适用于有残余听力患者;仍无效者可分别采用迷路切除术和前庭神经切除术.对梅尼埃病患者各个阶段的治疗尚无国际统一的治疗方法.     

梅尼埃病诊断研究进展

梅尼埃病是一种原因不明的 ,以膜迷路积水为基本病理特征的内耳疾病 ,膜迷路积水如何产生原因不明。梅尼埃病缺少病因诊断给医生和患者带来很大的困惑。为了正确地诊断梅尼埃病 ,必须综合应用电生理、影像学和免疫学检查 ,本文就梅尼埃病诊断研究进展进行综述     

耳源性眩晕病毒学研究

关于耳源性眩晕的病因学假说很多,其中病毒感染学说占据重要地位.本文综述了耳源性眩晕病毒学研究进展,提供了包括病原学、流行病学、血清学、组织形态学、临床观察和抗病毒治疗效果以及动物实验等方面的研究证据.目前的研究未能完全满足病毒作为直接病因的感染性疾病的科赫法则.本文对此进行解释,并对进一步的研究进行综述.     

鼓室注入庆大霉素治疗梅尼埃病的再思考

自从“化学性迷路切除术”的概念引入临床,鼓室注入庆大霉素治疗梅尼埃病一度成为临床热点。但近十年过去了,其临床推广受限。本文从医学伦理,合理的临床研究设计的角度出发,对治疗过程中畿需解决的关键问题进行综述。     

内淋巴囊神经分布与梅尼埃病相关性

梅尼埃病(Meniere's disease,MD)的基本病理改变为膜迷路积水.能够引起内淋巴囊分泌和吸收功能障碍的许多因素都可能引起膜迷路积水,而其中的一个重要因素就是局部血流的调节,它可被自主神经所影响.因此,自主神经功能紊乱自然就成为膜迷路积水或梅尼埃病的可能原因之一.     

COCH基因及其相关研究

COCH基因是人类发现的第一个伴前庭功能障碍的常染色体显性遗传非综合征性耳聋基因,COCH基因突变患者可出现一系列耳蜗、前庭功能障碍症状.目前,COCH基因及其编码的Cochlin蛋白功能,以及COCH基因是否为梅尼埃病致病基因都是研究的热点.本文就COCH基因及其相关研究进行了综述.     

梅尼埃病研究新动态

梅尼埃病（Meniere disease，MD）是一种特发的内耳病，主要病理特征是膜迷路积水。关于其发病因素有很多学说。本文就激素水平变化、自身免疫、遗传因素方面的最新研究做一综述。     

梅尼埃病诊治的教学刍议

梅尼埃病(meniere’s disease,MD)是一种以膜迷路积水为主要组织病理学特征的内耳病,以反复发作眩晕、伴波动性听力下降、耳鸣和耳胀满感为主诉,其发病率和患病率,文献报告有差异,可能与诊断标准不一致等因素有关。据北京市耳鼻咽喉科研究所报告,梅尼埃病占耳源性眩晕的61%～64     

The vestibular aqueduct in Meniere's disease.

The vestibular aquaeduct was evaluated blindly in tomograms from patients with Meniere's disease or chronic otitis and from patients without ear disorders. The descending part of the aquaeduct was clearly visible in 95% of the patients without ear disease. In the two other groups, it was visible only in about 50%. It is suggested that a narrow or invisible vestibular aquaeduct is an unspecific radiological sign in a variety of ear diseases.     

The role of immunological factors in Meniere's disease

Involvement of the immunological mechanisms in the pathogenesis of Meniere's disease has been discussed over the past two decades. Nevertheless, we lack well-defined laboratory tests that might confirm the autoimmune background of the disorder. Therefore the diagnosis is often based solely on the patient's clinical profile and the positive response to the immunosuppressive therapy. In this article we present a case of 44 year-old woman with Meniere's disease successfully treated with systemic glucocorticoids. The pathogenesis, diagnosis and management of immune-mediated cases of Meniere's disease are reviewed.     

Bilaterality of Meniere's disease

The audiometric configurations of a randomly selected group of 360 patients with clinical Meniere's disease were analysed in conjunction with their clinical manifestations. Although 78.6% of the patients had an abnormal pure-tone audiogram in the opposite ear from that which was initially diagnosed as Meniere's disease, based on the entire clinical picture, the disease was found to be definitely bilateral in 32% of the patients. A peaking audiogram type was found to be most common, occurring in about half of the involved ears. In approximately half of those with bilateral disease the second ear became involved within two years of onset of involvement of the first ear, and in another 27% the second ear became involved after a period of 5 years or more. These observations stress the importance of conservation in managing Meniere's disease, especially when considering surgical intervention for intractable disease, with the hope of retaining or restoring labyrinthine function.     

Postural instability in Meniere's disease

In order to characterize the postural instability by duration of Meniere's disease (MD) we present the results of 180 MD patients tested on posturography. The duration of the disease varied from 4 weeks to 36 years. The patients were clinically examined and they had filled a questionnaire concerning their symptoms. Postural instability was examined by a force platform posturography and the results are expressed as sway velocities (SV). There was no statistically significant difference in the mean SV between groups of different duration of MD. The number of the patients with normal eyes open SV declined by duration of the illness from 73% to 38% but the decline was not statistically significant. The mean age in the different duration groups of MD varied from 47 to 61 years. In general 58% of the patients had their eyes open SV in normal range and 55% when measured eyes closed. When examining the SV between the 4 different hearing stages of MD we found that those belonging into the group III (pure tone average [PTA] 41-70 dB) had significantly higher eyes open and eyes closed SV's than the patients in the group I (PTA under 25 dB).