What We Know so Far about Menier's Disease - Literature Review of the Connection between the Etiopathogenesis and Current Treatment Approaches
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Franču ārsts Prospers Menjērs 1861. gadā aprakstīja slimību, kuru vēlāk nosauca viņa vārdā, apkopojot raksturīgos simptomus - epizodisks vertigo, līdzsvara traucējumi, troksnis ausīs un sensorineirāls dzirdes zudums. Kopš tā laika šī stāvokļa etiopatoģenēze tika plaši apspriesta un tika veikti pētījumi, lai atrastu precīzu pamatcēloni. Pagaidām neviena etioloģiskā teorija nav vispārpieņemta. Tomēr tika izstrādātas konservatīvas un ķirurģiskas ārstēšanas metodes, kuras piedāvāt personām ar šādiem simptomiem. Menjēra slimības ārstēšanas pieejai, kas pamatota patofizioloģiski ir nepieciešami pētāma un.
Mērķis: Šī darba mērķis bija apkopot informāciju par nesen publicētajiem zinātniskajiem rakstiem par Menjēra slimības etioloģiju un ārstēšanas iespējām, salīdzināt noteiktu ārstēšanas pieeju efektivitāti saistībā ar simptomatoloģu slimības gaitā un ieteikt iespējamās jaunās ārstēšanas pieejas.
Metodes: Literatūras apskats tika veikts, izmantojot 99 rakstus, kas tika analizēti un salīdzināti. Tāpēc PubMed, ProQuest un ScienceDirect datubāzēs tika veikta meklēšana, izmantojot medicīnas tu virsrakstus (MeSH).
Rezultāti: Rezultāti liecina, ka etioloģiskās teorijas joprojām nav pārliecinošas un ir diskutējamas. Galvenais histoloģiskais marķieris ir endolimfātiskais hidrops, uz ko balsta patofizioloģiskās teorijas. Slimības attīstībā atrasta saistība ar ģenētiskām un hormonālās regulēšanas mehānismu izmaiņām, kam piešķir arvien lielāku nozīmi, par ko liecina šajos virzienos pieaugošais pētījumu skaits. Menjēra slimības attīstībā nozīme ir imūnās atbildes reakcijai un alerģiskām reakcijām, kā arī iekšējās auss išēmiskajiem procesiem, lai gan rezultāti ir nepārliecinoši. Līdz šim pielietotā ārstēšanas pieeja nenovērš galveno cēloni. Slimības simptomu mazināšanai izmanto konservatīvas metodes (piemēram, dzīvesveida maiņa, medikamenti), kā arī manipulācijas (piemēram, medikamentu intratimpanāla ievadīšana, ķirurģija). Diemžēl šīs pieejas ir vairāk eksperimentālas un pilnībā neaptver slimības attīstības cēloņus. Tāpēc ir ļoti nepieciešami plašāki un mērķtiecīgāki pētījumi, lai noteiktu Menjēra slimības etioloģiju, uz kā balstīt tās terapiju.
Secinājums: Menjēra slimību joprojām uzskata par multifaktoriālu slimību, ko predisponē ārēji un iekšēji faktori. Lai noskaidrotu Menjēra slimības ārstēšanas iespējas, ir nepieciešams turpināt veikt tās etiopatoģenēzes pētījumus.
Introduction: Ménière’s disease was coined in 1861 by Prosper Ménière summarizing the symptoms of vertigo, balance problems, tinnitus, and sensorineural hearing loss. Since then, the etiopathogenesis of this condition was highly discussed and multiple studies were attempted to find the exact underlying cause. For now, no etiological theory is universally accepted. Nevertheless, conservative and surgical treatment options were developed and are offered to affected individuals. The connection and concordance of treatment approaches and pathophysiology of Ménière’s disease still need deeper research and verification. Aim: This work aimed to collect information on newly published scientific articles on the research of etiologies and treatment options for Ménière’s disease. Additionally, based on the newest research the aim was to elaborate on the effectiveness of certain treatment approaches on the disease progression and symptomatology in regards to their genesis and suggest possible new approaches to treatment. Methods: A literature review was conducted on 99 articles, that were analyzed and compared. Therefore, PubMed, ProQuest, and ScienceDirect databases were searched, with the help of medical subject headings (MeSH). Results: The results show that etiological theories are still inconclusive and remain debatable. The main histological marker continues to be the endolymphatic hydrops and the pathophysiological theories are focusing on its development of it. Familial inheritance, genetic variations, and hormonal regulation mechanisms seem to gain importance the more research is done. The role of the immune response, allergic reactions, and ischemic processes of the inner ear play a role, although the results are inconclusive. Treatment approaches that have been applied are not addressing the underlying cause. Conservative methods (e.g., lifestyle changes, medication), but also interventions (e.g., intratympanic drug administrations, surgeries) are provided. Unfortunately, all these procedures are more experimental and do not fully cover the grounds for developing this condition. Hence, there is a critical need for deeper and more focused research to identify the etiology of Ménière’s disease.
Introduction: Ménière’s disease was coined in 1861 by Prosper Ménière summarizing the symptoms of vertigo, balance problems, tinnitus, and sensorineural hearing loss. Since then, the etiopathogenesis of this condition was highly discussed and multiple studies were attempted to find the exact underlying cause. For now, no etiological theory is universally accepted. Nevertheless, conservative and surgical treatment options were developed and are offered to affected individuals. The connection and concordance of treatment approaches and pathophysiology of Ménière’s disease still need deeper research and verification. Aim: This work aimed to collect information on newly published scientific articles on the research of etiologies and treatment options for Ménière’s disease. Additionally, based on the newest research the aim was to elaborate on the effectiveness of certain treatment approaches on the disease progression and symptomatology in regards to their genesis and suggest possible new approaches to treatment. Methods: A literature review was conducted on 99 articles, that were analyzed and compared. Therefore, PubMed, ProQuest, and ScienceDirect databases were searched, with the help of medical subject headings (MeSH). Results: The results show that etiological theories are still inconclusive and remain debatable. The main histological marker continues to be the endolymphatic hydrops and the pathophysiological theories are focusing on its development of it. Familial inheritance, genetic variations, and hormonal regulation mechanisms seem to gain importance the more research is done. The role of the immune response, allergic reactions, and ischemic processes of the inner ear play a role, although the results are inconclusive. Treatment approaches that have been applied are not addressing the underlying cause. Conservative methods (e.g., lifestyle changes, medication), but also interventions (e.g., intratympanic drug administrations, surgeries) are provided. Unfortunately, all these procedures are more experimental and do not fully cover the grounds for developing this condition. Hence, there is a critical need for deeper and more focused research to identify the etiology of Ménière’s disease.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Menjēra slimība, etiopatoģenēze, ārstēšana., Ménière’s disease, etiopathogenesis, treatment