Болезнь Меньера – заболевание внутреннего уха, характеризующееся периодическими приступами системного головокружения, флуктуирующей низкочастотной сенсоневральной тугоухостью, заложенностью и шумом в ушах. В статье представлены эпидемиологические данные по распространенности этого заболевания, теории патогенеза, приводящие к гидропсу лабиринта, проведен обзор диагностических методик, включая тональную пороговую аудиометрию, электрокохлеографию, дегидратационный тест, видеонистагмографию, калорическую пробу, видеоимпульсный тест и вызванные вестибулярные миогенные потенциалы. Также рассмотрены всевозможные как консервативные, так и хирургические методы лечения, в том числе гипосолевая диета, назначение бетагистина дигидрохлорида, глюкокортикостероидов, гентамицина, диуретиков, вестибулярной реабилитации, применение прибора Menniett, операции на эндолимфатическом мешке и протоке, селективная вестибулярная нейрэктомия, хирургическая аблация лабиринта и др.
Ménière's disease is an inner ear disorder, characterized by recurrent attacks of vertigo associated with fluctuating hearing loss, tinnitus and a sense of fullness in the ear and a fluctuating hearing loss. In this paper we present a review on epidemiology and incidence of this disease, pathogenesis of endolymphatic hydrops and diagnostic tools, including pure tome audiometry, electrocochleography, dehydratation test, videonystagmography, caloric test, video head impulse test and vestibular evoked myogenic potentials. Different treatment options, such as salt reduction diet, betahistine, diuretics, steroids, gentamicin, vestibular rehabilitation, Meniett therapy, endolymphatic sac and duct surgery, vestibular nerve section and surgical ablation, are also discussed.
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12. Gürkov R, Flatz W, Louza J et al. In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Ménière’s disease. Otol Neurotol 2012; 33 (6): 1040–5. Doi: 10.1097/MAO.0b013e31825d9a95.
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17. Merchant SN, Adams JC, Jr. Nadol JB. Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol 2005; 26 (1): 74–81.
18. Selmani Z, Marttila T, Pyykkö I. Incidence of virus infection as a cause of Meniere's disease or endolymphatic hydrops assessed by electrocochleography. Eur Arch Otorhinolaryngol 2005; 262 (4): 331–4.
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1. Minor LB, Schessel DA, Carey JP. Ménière's disease. Curr Opin Neurol 2004; 17 (1): 9–16.
2. Sagalovich B.M., Pal'chun V.T. Bolezn' Men'era. M.: Moskovskoe informatsionnoe agentstvo, 1999. [in Russian]
3. Baloh RW. Prosper Meniere and his disease. Arch Neurol 2001; 58: 1151–6.
4. Arenberg IK, Countryman LF, Bernstein LH, Jr. Shambaugh GE. Van Gogh had Meniere’s disease and not epilepsy. JAMA 1990; 264: 491–3.
5. Stephens D, Mudry A. Ménière’s disorder: a short history. Audiol Med 2012; 10: 153–9.
6. Alexander TH, Harris JP. Current epidemiology of Meniere's syndrome. Otolaryngol Clin North Am 2010; 43 (5): 965–70. Doi: 10.1016/j.otc.2010.05.001.
7. Choung YH, Park K, Kim CH et al. Rare cases of Ménière’s disease in children. J Laryngol Otol 2006; 120 (4): 343–52.
8. Shojaku H, Watanabe Y, Fujisaka M et al. Epidemiologic characteristics of definite Ménière’s disease in Japan. A long-term survey of Toyama and Niigata prefectures. ORL J Otorhinolaryngol Relat Spec 2005; 67 (5): 305–9.
9. Neuhauser HK, Von Brevern M, Radtke A et al. Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology 2005; 65 (6): 898–904.
10. Brandt T, Dieterich M, Strupp M. Vertigo and dizziness – common complaints. 2. London: Springer; 2013.
11. Levina Iu.V., Kunel'skaia N.L., Krasiuk A.A., Baush Ia.A. Epidemiologicheskaia kharakteristika bol'nykh, stradaiushchikh kokhleovestibuliarnymi narusheniiami pri gidropse labirinta. Vestn. otorinolaringologii. 2011; 4: 40–2. [in Russian]
12. Gürkov R, Flatz W, Louza J et al. In vivo visualized endolymphatic hydrops and inner ear functions in patients with electrocochleographically confirmed Ménière’s disease. Otol Neurotol 2012; 33 (6): 1040–5. Doi: 10.1097/MAO.0b013e31825d9a95.
13. Schuknecht HF. Meniere's disease: a correlation of symptomatology and pathology. Laryngoscope 1963; 73: 651–65.
14. Yeh TH, Herman P, Tsai MC et al. A cationic nonselective stretch-activated channel in the Reissner's membrane of the guinea pig cochlea. Am J Physiol 1998; 274 (3 Pt. 1): C566–76.
15. Tsuji K, Velázquez-Villaseñor L, Rauch SD et al. Temporal bone studies of the human peripheral vestibular system. Meniere's disease. Ann Otol Rhinol Laryngol Suppl 2000; 181: 26–31.
16. Honrubia V. Pathophysiology of Meniere's disease. Meniere's Disease (Ed. J.P.Harris) 1999; p. 231–60; Pub: Kugler (The Hague).
17. Merchant SN, Adams JC, Jr. Nadol JB. Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol 2005; 26 (1): 74–81.
18. Selmani Z, Marttila T, Pyykkö I. Incidence of virus infection as a cause of Meniere's disease or endolymphatic hydrops assessed by electrocochleography. Eur Arch Otorhinolaryngol 2005; 262 (4): 331–4.
19. Tyrrell JS, Whinney DJ, Ukoumunne OC et al. Prevalence, associated factors, and comorbid conditions for Ménière's disease. Ear Hear 2014; 35 (4): e162-9. Doi: 10.1097/AUD.0000000000000041.
20. Lee JM, Kim MJ, Jung J et al. Genetic aspects and clinical characteristics of familial Meniere's disease in a South Korean population. Laryngoscope 2015; 125 (9): 2175–80. Doi: 10.1002/lary.25207.
21. Candreia C, Schmuziger N, Gürtler N. Molecular analysis of aquaporin genes 1 to 4 in patients with Ménière's disease. Cell Physiol Biochem 2010; 26 (4–5): 787–92. Doi: 10.1159/000322346.
22. Cabrera S, Sanchez E, Requena T et al. Intronic variants in the NFKB1 gene may influence hearing forecast in patients with unilateral sensorineural hearing loss in Meniere's disease. PLoS One 2014; 9 (11): e112171. Doi: 10.1371/journal.pone.0112171.
23. Kriukov A.I., Fedorova O.K., Antonian R.G. i dr. Klinicheskie aspekty bolezni Men'era. M.: Meditsina, 2006. [in Russian]
24. Nabi S, Parnes LS. Bilateral Ménière's disease. Curr Opin Otolaryngol Head Neck Surg 2009; 17 (5): 356–62. Doi: 10.1097/MOO.0b013e3283304cb3.
25. Huppert D, Strupp M, Brandt T. Long-term course of Menière's disease revisited. Acta Otolaryngol 2010; 130 (6): 644–51. Doi: 10.3109/00016480903382808.
26. Zingler VC, Cnyrim C, Jahn K et al. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. Ann Neurol 2007; 61 (6): 524–32.
27. Odkvist LM, Bergenius J. Drop attacks in Meniere’s disease. Acta Otolaryngol 1988; 455: 82–5.
28. Lopez-Escamez JA, Carey J, Chung WH et al. Diagnostic criteria for Menière's disease. Consensus document of the Bárány Society, the Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. Acta Otorrinolaringol Esp 2016; 67 (1): 1–7. Doi: 10.1016/j.otorri.2015.05.005.
29. Friberg U, Stahle J, Svedberg A. The natural course of Meniere's disease. Acta Otolaryngol Suppl 1984; 406: 72–7.
30. Palomar-Asenjo V, Boleas-Aguirre MS, Sánchez-Ferrándiz N, Perez Fernandez N. Caloric and rotatory chair test results in patients with Ménière's disease. Otol Neurotol 2006; 27 (7): 945–50.
31. Oosterveld WJ. Menière's disease, signs and symptoms. J Laryngol Otol 1980; 94 (8): 885–92.
32. Black FO, Kitch R. A review of vestibular test results in Meniere's disease. Otolaryngol Clin North Am 1980; 13 (4): 631–42.
33. Park HJ, Migliaccio AA, Della Santina CC et al. Search-coil head-thrust and caloric tests in Ménière's disease. Acta Otolaryngol 2005; 125 (8): 852–7.
34. McGarvie LA, Curthoys IS, MacDougall HG, Halmagyi GM. What does the head impulse test versus caloric dissociation reveal about vestibular dysfunction in Ménière's disease? Ann NY Acad Sci 2015; 1343: 58–62. Doi: 10.1111/nyas.12687.
35. Bronstein A. Oxford Textbook of Vertigo and Imbalance. Barcelona: Oxford University Press, 2013.
36. Rauch SD, Zhou G, Kujawa SG et al. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière's disease. Otol Neurotol 2004; 25 (3): 333–8.
37. Egami N, Ushio M, Yamasoba T et al. The diagnostic value of vestibular evoked myogenic potentials in patients with Meniere's disease. J Vestib Res 2013; 23 (4–5): 249 57. Doi: 10.3233/VES-130484.
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Авторы
В.Т.Пальчун*, А.Л.Гусева, Ю.В.Левина
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*lorrsmu@mail.ru
________________________________________________
V.T.Palchun*, A.L.Guseva, Y.V.Levina
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*lorrsmu@mail.ru