メニエール病の素因の検索

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  • Examination of Predisposition to Meniere's Disease
  • メニエールビョウ ノ ソイン ノ ケンサク

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The predisposition to Meniere's disease was examined using a three-step method: (1) investigation of the etiologic factors by means of a questionnaire, (2) routine internal and laboratory examinations and (3) loading equilibrium examination.<br>In the investigation of the etiologic factors, which is a first step, past history of systemic and local diseases were sought. With local etiologic factors, special emphasis was laid on a history of hearing loss and otitis media.<br>In the routine internal and laboratory examinations performed as a second step, disorders of the circulatory system, autonomic nervous system, metabolic system, electrolytes, blood, liver function and neck were examined and the Cornell Medical Index evaluated.<br>At the loading equilibrium examination, a third step, the patients received loading and labyrinthine equilibrium disturbances were recorded using a stabilometer. The loads given were orthostatic loading, pressure upon the carotid sinus, pressure upon the eyeballs, neck torsion, retroflexion of the neck and vibration of the neck muscles. It was considered that positive results in the loading equilibrium examination were the most important etiologic factors in the disorders of the inner ear.<br>Eighty-four patients with Meniere's disease were involved in the study. Controls were 105 adults. The chi-square test was used to analyze the difference between the two groups.<br>As a result, the patients with Meniere's disease showed the following abnormalities.<br>(1) Questionnaire<br>a) General factors: circulatory disorders (67%), autonomic disturbance (57%), blood disorders (27%), neurological disorders (30%), etc.<br>b) Local factors: preexistent hearing loss (27%), tinnitus (29%)<br>(2) Internal and laboratory examinations<br>Circulatory disturbance (81%), metabolic disorders (77%), liver failure (65%)<br>(3) Loading equilibrium examination<br>Orthostatic loading (22%), pressure upon carotid sinus (54%), pressure upon eyeballs (41%)<br>These results indicated that Meniere's disease may be an ailment of the inner ear caused by a variety of local and systemic abnormalities. Furthermore, the examinations for predisposition to Meniere's disease were useful in planning for a causal treatment of Meniere's disease.

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