Santosh U P, Rao M S Sudhakar
Professor, Department of ENT, JJM Medical College , Davanagere, Karnataka, India .
Post Graduate Student, Department of ENT, JJM Medical College , Davanagere, Karnataka, India .
J Clin Diagn Res. 2016 May;10(5):MC01-3. doi: 10.7860/JCDR/2016/17587.7759. Epub 2016 May 1.
Meniere's disease is a disorder of the membranous labyrinth of the inner ear manifesting as vertigo, tinnitus, sensory neural hearing loss and aural fullness of known or unknown origin. Some patients may present after years into typical forms. The endocrine disorders, especially hypothyroidism and the factors like inflammation, trauma, otosclerosis, autoimmunity explains the multifactorial causation for the basis of Meniere's disease. Endolymphatic hydrops is the pathologic term named for the defective regulation of endolymph volume with respect to production and absorption. However, hyper production of endolymph cannot be excluded. The cause of Meniers disease is multifactorial so clinical features of repeated attacks of variable duration cannot be explained satisfactorily based on single causation.
To study the incidence of hypothyroidism in Meniere's disease and to assess the success rate of improvement in subjective symptoms after treatment.
The study was carried out on total 35 out patients who were clinically diagnosed of Meniere's disease and of these 35 patients, 12 patients were found to have hypothyroidism. All patients with hypothyroidism were treated with oral thyroxin supplements and they were evaluated clinically at 3 weeks, 3 months and 6 months interval for the improvement in subjective symptoms on outpatient basis.
In our study, the subjective improvement of all symptoms was seen in all cases of Meniere's disease with hypothyroidism after 12 weeks of treatment.
The improvement in clinical symptoms after treatment demonstrates an association between Meniere's disease and hypothyroidism which was found to be significant. Hence, clinicians should consider screening patients with Meniere disease for thyroid dysfunction who are not already taking supplements.
梅尼埃病是一种内耳膜迷路疾病,表现为眩晕、耳鸣、感音神经性听力损失和耳胀满感,病因已知或未知。一些患者可能在数年之后才出现典型症状。内分泌失调,尤其是甲状腺功能减退以及炎症、创伤、耳硬化、自身免疫等因素解释了梅尼埃病的多因素病因基础。内淋巴积水是一个病理学术语,指内淋巴在产生和吸收方面调节缺陷。然而,不能排除内淋巴产生过多的情况。梅尼埃病病因是多因素的,因此基于单一病因无法令人满意地解释其持续时间可变的反复发作的临床特征。
研究梅尼埃病患者甲状腺功能减退的发生率,并评估治疗后主观症状改善的成功率。
对35例临床诊断为梅尼埃病的门诊患者进行了研究,其中12例患者被发现患有甲状腺功能减退。所有甲状腺功能减退患者均接受口服甲状腺素补充剂治疗,并在门诊每隔3周、3个月和6个月进行临床评估,以观察主观症状的改善情况。
在我们的研究中,所有患有甲状腺功能减退的梅尼埃病患者在治疗12周后所有症状均有主观改善。
治疗后临床症状的改善表明梅尼埃病与甲状腺功能减退之间存在关联,且这种关联具有显著性。因此,临床医生应考虑对未服用补充剂的梅尼埃病患者进行甲状腺功能障碍筛查。