七年制医学课件 耳鼻喉 12menieres

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1、Meniere’sDiseasePresentedBy:ZhouJianrongPh.D.Whatisit?Aninnereardisorderthatcausesonetoexperienceperiodsofvertigo（眩晕）,fluctuatingsensorineuralhearingloss（波动性感音神经性耳聋）,tinnitus（耳鸣）andauralpressure（耳胀满感）.Endolymphatichydrops（内淋巴水肿）intheinnerearCauses(cont

2、)Herpesvirus（疱疹病毒）(HSV)antibodiesarefoundmorecommonlyinMeniere'spatients.Morerecentpathologicdataissupportingitsviralcause.Causes(cont)About60%ofpatientswithMeniere'sdiseasehaveserumantibodiesagainstinnerearproteins.About10%ofMeniere'spatientshavewelld

3、ocumentedautoimmunedisorders.SomeMeniere'spatientsshowevidenceforachangeintheirimmunityaroundthetimeoftheirattacks.Causes(cont)TheinnerearCausesItisassociatedwithachangeinfluidvolumeintheinnerear.Themembranouslabyrinth（膜迷路）,whichisencasedbybone,isneces

4、saryforhearingandbalanceandisfilledwithafluidcalledendolymph（内淋巴液）.Causes(cont)Anincreaseinendolymph,however,cancausethemembranouslabyrinthtoballoonordilate,aconditionknownasendolymphatichydrops.Reasonablepossibilitiesareobstructionofendolymphaticoutfl

5、owattheendolymphaticduct（内淋巴管）level,increasedproductionofendolymph,orreducedabsorptionofendolymphcausedbyadysfunctionalendolymphaticsac（内淋巴囊）.Whatarethesymptoms?Episodicrotationalvertigo（发作性视物旋转性眩晕）(attacksofaspinningsensation)Fluctuatinghearingloss（波动

6、性听力下降）Tinnitus（耳鸣）(aroaring,buzzing,orringingsoundintheear)Sensationoffullness（耳胀满感）intheaffectedearClinicalexaminationTheeardrumisnormalThefunctionoftheeustachiantube（咽鼓管）isnormalTympanogram(鼓室图)isnormalNystagmus（眼震）canbeseenduringacuteattackAudiometr

7、y（听力测验）presentationissensorineuralhearinglossClinicalexaminationDiagnosisofMeniere’sDiseaseRecurrentepisodicrotationalvertigoaccompaniedbynausea(lasting20mintohours,atleast2times),normalconsciousnessSensorineuralhealingloss(atleast1time)TinnitusAuralfu

8、llnessOtherdiseasesexcludedDisordersofbalance-OtherdiseasesVestibularneuritis（前庭神经元炎）Suddendeafness（突发性耳聋）Epilepsy（癫痫）ManaginganattackLaydownonafirmsurfaceStaymotionlessKeepeyesopenandfixedonastationaryobjectDon’tdrinkwaterAfterspinning