Meniere's disease
Meniere's disease
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DOI：
10.1038/nrdp.2016.28
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发表时间：
2016-05-12
影响因子：
81.5
通讯作者：
Young, Yi-Ho
中科院分区：
文献类型：
--
作者：
Nakashima, Tsutomu;Pyykko, Ilmari;Young, Yi-Ho
梅尼埃病（MD）是一种内耳疾病，可引起眩晕发作、波动性听力损失、耳鸣和耳闷。MD的病因是多因素的。MD的特征性体征是内淋巴水肿（EH），这是一种其中过多的内淋巴在内耳中积聚并导致神经节细胞损伤的病症。在大多数患者中，MD的临床症状出现在内淋巴大量积聚之后。然而，一些患者在EH的早期阶段出现症状。高血压与MD临床症状的关系尚需进一步研究。MD的诊断是基于临床症状，但可以补充功能性内耳测试，包括测听，前庭诱发肌源性电位测试，热量测试，耳蜗电图或头部脉冲测试。磁共振成像已被优化，直接可视化高血压在耳蜗，前庭和半规管，其使用正在从研究环境转移到临床。MD的治疗主要针对缓解眩晕急性发作和预防复发。治疗方案以经验证据为基础，包括风险因素的管理和作为一线治疗的保守方法。当药物治疗无法抑制眩晕发作时，通常会考虑鼓室内庆大霉素治疗或内淋巴囊减压手术。本书涵盖了MD的病理生理学、病理学、诊断、管理、生活质量和预防。
Meniere's disease (MD) is a disorder of the inner ear that causes vertigo attacks, fluctuating hearing loss, tinnitus and aural fullness. The aetiology of MD is multifactorial. A characteristic sign of MD is endolymphatic hydrops (EH), a disorder in which excessive endolymph accumulates in the inner ear and causes damage to the ganglion cells. In most patients, the clinical symptoms of MD present after considerable accumulation of endolymph has occurred. However, some patients develop symptoms in the early stages of EH. The reason for the variability in the symptomatology is unknown and the relationship between EH and the clinical symptoms of MD requires further study. The diagnosis of MD is based on clinical symptoms but can be complemented with functional inner ear tests, including audiometry, vestibular-evoked myogenic potential testing, caloric testing, electrocochleography or head impulse tests. MRI has been optimized to directly visualize EH in the cochlea, vestibule and semicircular canals, and its use is shifting from the research setting to the clinic. The management of MD is mainly aimed at the relief of acute attacks of vertigo and the prevention of recurrent attacks. Therapeutic options are based on empirical evidence and include the management of risk factors and a conservative approach as the first line of treatment. When medical treatment is unable to suppress vertigo attacks, intratympanic gentamicin therapy or endolymphatic sac decompression surgery is usually considered. This Primer covers the pathophysiology, symptomatology, diagnosis, management, quality of life and prevention of MD.