Therapy of Meniere's disease

Synonyms

Meniere's disease

definition

Menière'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.

therapy

Treatment of Menière's disease should be prompt, if possible at the first occurrence of the symptom complex are made to a complete expression the disease to avoid. Although the exact cause of the disease is still unknown, the pathomechanism of the disease is largely clear and can Treated symptomatically.

In the first place here are a number of drugs, most notably one Pressure relief of the inner ear should bring about:

• Dehydration drugs (Diuretics).
• dizziness-reducing drugs (Antiemetics) Betahistin®

There is a lot of research going on in the field of drug treatment for Menière's disease today, and some promising study results with new drugs remain to be seen.

In addition to drug treatment, some also apply other causes clarify and treat the consequences of the disease:

• orthopedic problems (Posture problems of the cervical spine)
• chronic malocclusion (Incorrect posture of the temporomandibular joint) a considerably higher risk of getting a new attack of Menière's disease than other patients. For this reason, missed bites should be corrected by a dentist and postural damage should be corrected orthopedically. This should round off the therapy of Menière's disease and reduce the frequency of attacks.

• psychological stress (anxiety disorders, Overcautiousness) In this case, an accompanying psychological care of the patient should be considered. At least as long as the symptoms are severe, fear training and psychological counseling should be carried out. Over time, depending on the frequency of seizures and the severity of the disease, the therapy can be reduced or finally stopped completely.

In addition to the drug methods and psychotherapeutic treatment options, there are numerous complementary ones operative and alternative forms of treatmentthat have different success rates.

1. Operational can through the eardrum a so-called

• Ventilation tubes inserted that ensures a direct connection between the middle and outer ear. In many patients, for whom drug treatment has not helped, this surgical treatment is very successful and the patients may be permanently symptom-free. Another benefit of a ventilation tube is that about it if necessary, medication directly into the middle ear can be given, which can then migrate into the inner ear. A ventilation tube can remain in the ear for a long time, but from time to time the correct position should be checked by an ENT specialist.

• Another surgical treatment for the disease is the Labyrinth anesthesia. Here is a small cut in the eardrum access to the middle ear is established. In this way a Anesthetics in the middle ear injected. This then migrates into the labyrinth system and can thus the Decrease metabolic processes and calm down. The treatment method is still relatively new, but initial results show that it seems to work. Due to the anesthesia, it can become one brief but violent attack of dizziness come before the positive effect of the treatment method takes effect.

• Tenotomy: here also the opened eardrum severed the muscles of the middle ear. This arguably leads to one general depressurization and thus to reduce the symptoms. The results of this treatment are very positive. The Balance organ contains fluid, the pressure of which increases sharply in Menièr's disease. The fluid is stored in a bony space in the base of the skull and cannot expand if necessary.

• In the operational Saccotomy becomes a Access behind the ear placed on this reservoir and the bony wall opened. This leads to the Pressure of the liquid better distribute can.

• operative transection of the equilibrium nerve if all treatment methods are unsuccessful. This engagement is more complicated and needs to be considered carefully as it is too strong side effects after the surgical transection. In some cases it can be too Facial nerve injuries come, furthermore, the severing of the equilibrium nerve goes with one irreversible failure of the organ of equilibrium hand in hand.

This means that the patients initially suffer from severe attacks of dizziness in the period after the procedure, which must then be trained off. If this succeeds, the patients have a good chance of leading a symptom-free life.

Nowadays the Severing the nerve only rarely carried out. Through one in the ear insertable pressure device, which exerts varying pressures through the middle ear into the inner ear, can also be tried to treat the disease.