Liječenje Meniereove bolesti

master's thesis

• Title (english): The treatment of Meniere's disease
• Author: Iva Tucić
• Mentor: Srećko Branica (mentor)
• Committee member: Srećko Branica (predsjednik povjerenstva)
• Committee member: Mario Bilić (član povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Meniereova bolest je bolest unutrašnjeg uha koja se manifestira karakterističnim trijasom
simptoma: vrtoglavicom, fluktuacijom sluha i šumom u uhu. Etiologija bolesti je nejasna.
Okidač za nastanak Meniereove bolesti može biti stres, imunološki poremećaj, poremećaj
metabolizma vode i elektrolita, vaskularni poremećaji te razna druga stanja. Bolest počinje
iznenada, slabljenjem sluha, šumom u uhu i vrtoglavicama koje su često praćene
vegetativnim simptomima mučnine i povraćanja. Nakon prestanka napadaja stanje bolesnika
se normalizira. U početku bolesti sluh fluktuira, ali ponavljanjem napadaja dolazi do
postupnog trajnog oštećenja sluha. Dijagnoza se postavlja na temelju anamneze i kliničke
slike.
Liječenje Meniereove bolesti može biti konzervativno i kirurško. Konzervativno liječenje se
provodi u početnoj fazi bolesti i sastoji se od sedativa, antivertiginoznih lijekova,
vazodilatatora, antihistaminika te kortikosteroida. Također, preporuča se smanjen unos soli u
organizam. Kad je bolest rezistentna na konzervativnu terapiju, preporuča se kirurško
liječenje. Postoje četiri skupine zahvata: lokalna primjena antibiotika u srednje uho,
destruktivni i drenažni zahvati te vestibularna neurektomija. Destruktivni zahvat se najčešće
izvodi intratimpanalnom aplikacijom ototoksičnog antibiotika. Drenažni zahvati omogućuju
otjecanje endolimfe preko endolimfatičkog sakusa u subarahnoidalni prostor. Vestibularna
neurektomija se izvodi selektivnom resekcijom vestibularnog živca, najčešće
retrosigmoidnim pristupom.

Abstract (english)

Meniere’s disease is a condition of the inner ear manifested by the triad of symptoms:
vertigo, fluctuating hearing and tinnitus. The etiology of the disease remains unclear.
Stress, immune system disorders, disorders of water and electrolyte metabolism, vascular
disorders as well as various other conditions can all trigger Meniere’s disease. The disease
starts suddenly with tinnitus and vertigo, often accompanied by symptoms of nausea and
vomiting. After such attacks, the patient’s condition tends to stabilize.
The disease starts with fluctuating hearing loss, but repeated attacks of Meniere’s result in
gradual permanent damage to patient’s hearing. The diagnosis is based on the anamnesis and
clinical features. The treatment of Meniere’s disease can be conservative and surgical.
Conservative treatment is applied at an early stage of the disease and includes sedation,
antivertigo medications, vasodilatators, antihistaminics and corticosteroids. Reducing salt
intake is also recommended. When the disease is resistant to conservative therapy, there is a
proposed surgical treatment. There are four surgical procedures: local application of
antibiotics in the middle ear, destructive and drainage procedure and vestibular neurectomy.
A destructive procedure is mostly carried out by intratympanal application of ototoxic
antibiotics. Drainage procedure releases endolymph through endolymphatic sac into
subarachnoid space. Vestibular neurectomy is carried out by selective resection of the
vestibular nerve, usually by the retrosigmoid approach.

• Keywords: Meniereova bolest; konzervativno liječenje; kirurško liječenje
• Keywords (english): Meniere's disease; conservative treatment; surgical treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:237900
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-05 11:41:22