Abstract:
Ménière\'s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Conventional imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many and typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies.
The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.
摘要:
梅尼埃病(MD)是一种由自发性眩晕发作(每次持续20分钟至12小时)定义的临床疾病,在受影响的耳朵之前有记录的低频至中频感音神经性听力损失,during,或者在眩晕发作之后.它还表现出波动的听觉症状(听力损失,耳鸣,或耳朵丰满)在受影响的耳朵中。MD的潜在病因尚不完全清楚,然而,它已经与内耳液(内淋巴)量增加有关,最终出现阵发性耳部症状(眩晕,波动性听力损失,耳鸣,和听觉丰满)。体格检查结果通常不明显,和听力测试可能会或可能不会显示低频到中频的感觉神经性听力损失。常规成像,如果执行,通常也是正常的。MD治疗的目标是预防或减少眩晕的严重程度和频率;缓解或预防听力损失,耳鸣,和听觉丰满;并提高生活质量。MD的治疗方法很多,通常包括生活方式因素的改变(例如,饮食)和医疗,外科,或多种疗法的组合。
本临床实践指南的主要目的是提高MD的诊断检查质量和治疗结果。为了达到这个目的,本指南的目标是利用现有的最佳已发表的科学和/或临床证据来提高诊断准确性和适当的治疗性干预措施(内科和外科),同时减少未指明的诊断性检查和/或影像学检查.