| Abstract | Ménièreova bolest poremećaj je membranoznog dijela unutarnjeg uha nejasne etiologije, a pogađa osobe srednje životne dobi. Prezentira se vrtoglavicom, jednostranom zamjedbenom nagluhošću i tinitusom. Često je praćena i vegetativnim simptomima povraćanja i mučnine, a moguće su i varijabilne prezentacije same kliničke slike. Napadaj bolesti dolazi naglo i bez upozorenja, a traje od 20 minuta do 2-3 sata. Po završetku atake simptomi se povlače, no napredovanjem bolesti zaostaje kronični gubitak sluha u području niskih frekvencija. Progresijom bolesti gubitak sluha zahvati cijelo frekvencijsko područje, a u dijela pacijenata bolest zahvati i kontralateralno uho. Od mogućih uzroka pretpostavljeni su upalni, autoimuni, virusni, vaskularni i genetski, a svi vode do nekog oblika endolimfatičnog hidropsa u unutrašnjem uhu. Dijagnoza bolesti je klinička, na temelju anamneze i klasičnih simptoma, a dopunjuje se audiološkim i vestibularnim testovima. Terapija je u prvoj liniji konzervativna i medikamentna, a u slučaju neuspjeha kontrole simptoma preporuča se kirurška. Konzervativno liječenje provodi se u početnoj fazi, a najčešće se koriste antihistaminici, antiemetici, diuretici, antivertiginozni lijekovi i sedativi, uz opće dijetetske mjere i promjenu prehrane. Po neuspjehu konzervativnog liječenja indicirano je kirurško, a dijeli se na nedestruktivne i destruktivne tehnike, ovisno o poštedi sluha. Glavni nedestruktivni tretmani su lokalna primjena kortikosteroida i drenažne operacije saccus endolymphaticusa, a destruktivni intratimpanična injekcija gentamicina i vestibularna neurektomija. |
| Abstract (english) | Ménière's disease is a disorder of the membranous part of the inner ear of unclear etiology, affecting middle-aged people. It presents itself with vertigo, unilateral sensorineural hearing loss and tinnitus. It is often accompanied by vegetative symptoms of vomiting and nausea, and variable presentations of the clinical picture are also possible. An acute attack of the disease comes suddenly and without warning, and lasts from 20 minutes to 2-3 hours. At the end of the attack, the symptoms disappear, but as the disease progresses, chronic hearing loss in the low-frequency range lags behind. As the disease progresses, hearing loss affects the entire frequency range, and in some patients, the disease also affects the contralateral ear. Possible causes include inflammatory, autoimmune, viral, vascular and genetic, all of which lead to some form of endolymphatic hydrops in the inner ear. The diagnosis of the disease is clinical, based on the classic symptoms, supplemented by audiological and vestibular tests. The first-line therapy is conservative and medicinal, and in case of failure of symptom control, surgery is recommended. Conservative treatment is carried out in the initial phase, and most often includes antihistamines, antiemetics, diuretics, antivertiginous drugs and sedatives, along with general dietary measures and a change in diet. After the failure of conservative treatment, surgical treatment is indicated, and it is divided into non-destructive and destructive techniques, depending on the preservation of hearing. The main non-destructive treatments are the local application of corticosteroids and drainage surgery of the saccus endolymphaticus, and the destructive ones are the intratympanic injection of gentamicin and vestibular neurectomy. |
