Ksenija Kuzborskaja-Riaukė¹

¹Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania

Abstract

Introduction. Meniere’s disease is an idiopathic disorder of the inner ear, clinically characterised by fluctuating sensory hearing loss, tinnitus, and sudden spontaneous recurrent attacks of vertigo. It‘s a multi-etiological condition, the onset and development of which is caused by the combined effects of genetic and environmental factors. The pathophysiology of Meniere’s disease is attributed to endolymphatic hydrops (excess fluid) in the labyrinth of the inner ear, possibly due to overproduction of endolymph or insufficient absorption. The treatment of Meniere’s disease is primarily aimed at reducing the frequency, course and severity of episodes of vertigo, tinnitus and impeding hearing loss. Treatment of acute episodes is symptomatic and further treatment is aimed at preventing progression of the disease and relieving symptoms.

Aim: to conduct a review of the scientific literature to clarify the treatment of Meniere’s disease.

Methods. PubMed and Google Scholar databases were used for the literature review. English-language articles were selected, with priority given to publications not older than 5 years. For the review, 56 articles were analysed for the period 1997-2022. 34 scientific publications were selected for review.

Conclusions. There isn‘t universally accepted treatment for Meniere’s disease. Conservative treatment with diet is used to halt the progression of the disease, if unsuccessful, treatment can be continued with betahistine, diuretics, intratympanic corticosteroids or gentamicin. Surgical procedures such as endolymphatic sac surgery, labyrinthectomy or vestibular neurectomy may be used to stop the symptoms.

Keywords: Meniere‘s disease, endolymphatic sac surgery, labyrinthectomy, vestibular neurectomy.

Full article

https://doi.org/10.53453/ms.2023.1.18

Treatment specifics in Meniere's disease: a review of the

literature

Ksenija Kuzborskaja-Riaukė

1

1

Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania

Abstract

Introduction.                         







!"

#

                            



Aim: 

Methods$ %&   '

()(*

+,,-./..01

Conclusions.2



          &          



Keywords:

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

Medical Sciences 2023 Vol. 11 (1), p. 138-146, https://doi.org/10.53453/ms.2023.1.18

138

Menjero ligos gydymo ypatumai: literatūros apžvalga

Ksenija Kuzborskaja-Riaukė

1

1

Lietuvos sveikatos mokslų universitetas, Medicinos akademija, Kaunas, Lietuva

Santrauka

Įvadas. 3        4        5  6  3

          3        6  5

3464738

993:33

44  4 3  43 

3%37;:9;739

7    7  7  3    4    7  <9  :9    

3395

Tikslas.=46;7553

Metodika.>6;?$@?%&@9:48

8    544  5      ;;    39  3A  B  ?

C      ?  B  ?  B  ?

B    ?  B?  B  ?    D    9  

5734(93E;75:

(*+,,-./..99F430143

Išvados.F463>;3

6G

          &9      6  

4653433

Raktažodžiai:353343

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

139

1.

2. Įvadas

3        4  

563

        

3          

      

  G    6  5

3        +"

33+/+(/

39+///// 39;5

40(1/9;

;4  ."464 7

389

9  0"%

      

6    +/  H  9    39    

54:4E

      73  

    :;  4



;

43 0"I99

    G  4  

4      4  

3    4  3  

3  1"  $;3  ;  

;;        4    

    5  4  3

  <:  3  (+/  9  

 0"

3:3./+(9

37353

34 ."

%  3  7      

;:9;739

7 7 7 3 

7<9:9

3

        69    

    ;  9  :9

4        ;3

      

3

    

37 ("

3. Metodika

>6  ;      

?$@?%&@9:4

885445

;;    39  3A  B

?  C      ?

B  ?  B

?  B    ?

B?  B  ?  

D    9    5  

  7  34    (  9

3E;75:(*

+,,-./..99

F430143

4. Rezultatai

3.1. Pirmasis gydymo žingsnis

3.1.1. Dieta

J4369K

53945

$  4    6    

33

;99

3    &    

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

140

&$2"  "  +"        

  5    4    8

=9    ;        

        ;  7

:5  5

4   :G *-" = 39

9  9  K9  7    4

3  L" 

;399

          

843 ,"M3

;83

  6  437  4

      

  +/"      33

:4;3

 +//    7"   8 3

643

4.1.2. Betahistinas

DN+9

      N0  9  

J8;

    :9  7    

737:4

3   43   :9

;  ++"D4

37      ;    K9

9      3  K

3  M 6    

:    9  9

44

4    7    

7 +."

F      3    

3   

9  8G    5    

      3  

 +0"O4

KJ39

  4    89  3  

      K  

        :9  7  

;7    4 +1+("

=4

K    

578

    7  K  4;  

      

4 +*+L"

4.1.3. Diuretikai

:      ;  3

3P;

; 68 48

449   

    7    ;7  =

3:48+,

9  +,"  5      3

  3        

        9

43 ./"M9

3  3    9  ;

      3      Q9

      7  

37 36;

;43      37

G  37      K7

37  4  :  

=944:

    4  53    4    

33 +,.+"

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

141

4.2. Antrasis gydymo žingsnis.

Intratimpaninis gydymas

kortikosteroidais

      

        

  3 :

  :  %  9

:37K

393K%

874:77

9K4

  3  ;3    &

"  .."  R    G  ;

K  43  K9  9

9  .0"

    3  

  9  9  3  

:43  .1"    4  3

;  9  K9  5  

3793;4

999

  .("  J9  K9

9  339  7  3

  7  5  

O4

  5  3  G  6    

943 .*.-"%

649

9  339  :K9  

9;3

 34" .*"

4.3. Trečiasis gydymo žingsnis. Endolimfinio

maišelio chirurgija

      5  

4    8  48    

:G    3  3    

3    :3  I  4

3  ;  7  43

43  4      4

    7      

6    .L"  S3  

  8  7    

5  37  J    

  6      5

      

5      M

  8    5

7  34  3 

      :

      

'53

      8  G    K737  .,"

>      5  4

6  3    3"

  5  3    6

;;46

;7

5        5  P

9  ;8  6  7

      4  4

:        5

3  3    00    ,1    0/"

K394

6      

9  3      4  5

34 .L"

4.4. Ketvirtasis gydymo žingsnis.

Intratimpaninės gentamicino injekcijos

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

142

M    4      

3  3    3

4  3  3  3

8 7  ("   4

  ;  :9  :4  ;;

7  7  K  7  P4

5  79    ;43  

      3  6  0+"    

4    74  

34  :    

"    4  

74557

;      :9  ;7  

7  F    4    

        :  4

5876

4;3  0."

5        9  9

K9  39  9    

      

      3  7

$      

9  K9      

      

    "  7  00"

$        

    ;43  

9KM

    :  4    

  5  ;43  

39

4339 00"./+*

9            

:

      7

9  K9  7  E:    

    :9  ;  

    33

;43L-H:,/H 01"

I35

        4  



4.5. Penktasis gydymo žingsnis. Chirurginis

gydymas

    3    4

3    ;7    

4  G    

    3    01"  24

3      

      ;

E337

3K69



Q=O    =33    '3    

K  ("  O4  3  

        5

5          

5      =

3    G  37

      K    

  39    

:9   7        7

7754 "

G37 ("

5. Išvados

F4      6  3  

  <9  :9  9  5G  

        

3        

5  >    

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

143

;3        

            6

G      



&9      6  

4  6      5

3    4  3

3  O  4      5  59

9483



Literatūros šaltiniai

+P>$22E%

)    E  S    )    

2    2  '  &  =  P

E          T

P././U.. ."A(V,

. 2QW S D&  N 2

  $    T  P

./+-U+(,V*-

0$: $>:: Q=2

X    2    

  T    PYA  =  &  E

./+,U+ .+."

12&2E$

NS

SNF&./+*U 1"A+,1

./1

(F!QDPQ%W

MP:O

2SF"     Z[  '

=SNFP./+LU+0(

+&A&.,&0.

*  P  '  \  E  $]  =  ^

    O  

          

_      ,1    E_N

E./+(U00/++,+.1

-  F  N  M  M    M

S    W    2  $  W

P.//*U+1((V*/

L  M    S  N  )  

&=JE:

    P  &  N

O$$T

P`=$&./+*U+V+0

,==&)>

TPYA=E:2

./+*U1 ."A*LV-+

+/  &a:    &ab:  '

&Z:&E:#&=

&a:        2    

[  T    YA      Yc

2[TYA

Yc./+-UL0/(A/VL

++)D&M&&&

2D'!PP

'2&OD)

%$O./+.U- *"A.V-

+.>N$NOPD

        Z[  T    

.//-U0 1"A1.,V1/

+0  O'  D     \>  NQ

D3P^D$$D

Z[TP&A=&

E_=F./.+U.-+

00

+1=2)2WQ%d

E  X ^ &' 

            

TA

        

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

144

 D''P"_

DQ./+*U0(.

+(NP=W&=>)

P  ^  &    D  

_2  P    &

E./+L

+*Qe:SF:)>

':=>'

$&P

TP./+LU+1 ."A0+-V.+

+-FQQ

      Z[T    

  _'  =    S

E>./+0U.-+LL-L,-

+L    '  %  %%$>    F>

SE&>$$$'$P

D          

.//0U-0V-

+,  $  =  )  %  %  E    2

D2PA

c_

./++U--(L*,-+

./  2    %  $  =    P  >  =

&E  P   

    Z[T

P_SVNF&

./+*U+(1L.1L01

.+$=D2)%%=



O'%)"!

            

!

           

./+/U0L0(

..  N  S  &  F  N  S

2ND

P./+.U+,10A+,.LV10

.0  M  N        N

P%E++

=  N!  P    

N'./+.U +0"

.1  >  $  Q  Df3  $  M  M  &  )

&%)

      A  

    

_NE.///U+10+L,+,*

.(  )    N    >  $  E  

$E2Z[

PA=X%

$    2    '

P_S^F./+,U.+(

.*  D Q  =    E &  =  & M

$>&P!

Z[PA=2

#_S^F./+-

.-2Q2J\DN2\D

&  D  2  =)    

E    &  M      '  

        

     A =  

      

_'20,./.+U///A+/+/L/

.L>P %b )P2 & >

'  &  &    Z[  T  

PV2S>E

./+-

.,\ %>JNQ> & \g =

2    >  '  &

P'&

W'&P

TPYA

=  &  )X    ./..U

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

145

+0A+VL

0/QM\MJNN

&P''=2=S)

EWQ'

 $ W [P X

'  &  P    &

&_S^F./+,

0+  E  =&      

TP'=

O22&=

&E./+,U L"

0.&P$%h'$&

' W  D M 2  Q $   "

    [T  PA  &

2  =    2_2

SE./+-(+0.+1+

00  2  J  >  N    %

    Z[T  P  S

./+,

01>JJQP2 

TYA=

S././U/ /"A+V(

Journal of Medical Sciences. 23 Jan, 2023 - Volume 11 | Issue 1. Electronic - ISSN: 2345-0592

146