メニエ-ル病の治療効果の判定 (メニエ-ル病の研究-3-<特集>)

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We report herein the examinations required for evaluation of the effects of treatment of Meniere's disease. Prior to the discussion, it is indispensable to clarify the design of the treatment. In the treatment, the authors take into consideration the following three subjects: (1) treatment of vertigo, (2) treatment of damage to the inner ear, and (3) treatment of recurrence of attacks of vertigo.(1) For evaluation of effects of treatment of vertigo in attacks and dizziness in the chronic stage of the disease, complaints of vertigo and spontaneous nystagmus as objective evidence of vertigo should be investigated. Furthermore, righting reflex and deviation test should be performed in order to demonstrate the mechanism of improvement of the vertigo. Despite the improvement obtained by inhibitory effects of drugs on the vertigo, the righting function and deviation phenomenon remain unchanged. On the contrary, when the pathological condition of the inner ear is healed there is an improvement of these signs.(2) Effects of the treatment for damage of the inner ear are evaluated by hearing and caloric tests. In cases where the labyrinthine excitability is not reversible, compensatory process of balancing activity of the body should be examined using the standing test, tests for spontaneous nystagmus, deviation and caloric tests and tests for postrotatory nystagmus. Disappearance of spontaneous nystagmus and deviation phenomenon reveal a recovery of static balance of the vestibular system. Disappearance of asymmetry of postrotatory nystagmus indicates a restoration of balance in the kinetic labyrinthine reflexes.(3) Recurrences of attacks of vertigo are treated on the basis of the results of examination of etiologic factors of Meniere's disease in each patient. Effects of this treatment should be evaluated by long-term follow-up of the vertiginous attacks.
耳鼻咽喉科臨床学会の論文

メニエ-ル病の治療効果の判定 (メニエ-ル病の研究-3-<特集>)

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