Equilibrium Research
Online ISSN : 1882-577X
Print ISSN : 0385-5716
ISSN-L : 0385-5716
シリーズ教育講座 「難治性めまいへのアプローチ」
5. メニエール病の外科治療
土井 勝美
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ジャーナル フリー

2014 年 73 巻 1 号 p. 8-15

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Meniere's disease is characterized by intermittent episodes of vertigo lasting from minutes to hours, with fluctuating sensorineural hearing loss, tinnitus, and aural pressure. The primary histopathological correlate is endolymphatic hydrops. Several medical and surgical treatments have been offered to patients with Meniere's disease. It has been confirmed that no one effective treatment is available for these patients. According to the severity of the patients' symptoms, appropriate therapeutic strategies should be selected. If medical therapies including lifestyle change, diuretics, and local/systemic steroids have failed, then surgical approaches such as intratympanic gentamicin perfusion (GM), pressure pulse treatment with Meniett®, endolymphatic sac surgery (ESS) and vestibular neurectomy (VN) should be considered. Most reviews have reported relative good (80-100%) vertigo control rates with either GM, Meniett®, ESS, or VN, however, recurrence of vertigo has been noticed in certain cases. A combination of medical and surgical strategies should be recommended and the treatment algorithm for Meniere's disease indicated in “2011 Clinical practice guidelines for Meniere's disease” must be adopted.
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© 2014 一般社団法人 日本めまい平衡医学会
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