ABSTRACT
Si los médicos utilizáramos los mismos conceptos al referirnos a la definición de Enfermedad de Menière (EM) y las mismas escalas para establecer los estadios o las valoraciones de un tratamiento podríamos contrastar nuestros resultados. Ello redundaría en beneficio de los enfermos porque permitiría facilitarles información más correcta sobre la evolución de la enfermedad y la eficacia de los posibles tratamientos. Con la incorporación de la informática surge un nuevo interés sobre estos principios porque se pueden conseguir bases de datos muy amplias aunando las que utiliza cada centro, siempre y cuando las normas de recogida de datos se hayan estandarizado previamente. En este trabajo valoramos las propuestas del "Committee on Hearing and Equilibrium" de la Academia Americana de Otolaringología (AAO) y de otros autores respecto a los planteamientos anteriores (AU)
If all doctors would use the same concepts to define Meniere's Disease (MD) and the same scale to either establish the different steps of the disease or to evaluate a specific treatment, it would be easy to compare our results. This would be beneficial for patients because of the possibility of giving them a more accurate information about the follow-up of their disease and the advantages of the different possibilities of treatment. Since the introduction of informatic systems a new goal appeared: large databases could be achieved, as a result of being able to gather the different database that are independently used in each hospital, provided that rules to establish data would be previously standardized. The purpose of this paper is to evaluate the proposal of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology and those proposed by other authors according to the stated courses of action (AU)
Subject(s)
Humans , Meniere Disease/diagnosis , Meniere Disease/therapy , Disease Progression , Severity of Illness IndexABSTRACT
If all doctors would use the same concepts to define Meniere's Disease (MD) and the same scale to either establish the different steps of the disease or to evaluate a specific treatment, it would be easy to compare our results. This would be beneficial for patients because of the possibility of giving them a more accurate information about the follow-up of their disease and the advantages of the different possibilities of treatment. Since the introduction of informatic systems a new goal appeared: large databases could be achieved, as a result of being able to gather the different database that are independently used in each hospital, provided that rules to establish data would be previously standardized. The purpose of this paper is to evaluate the proposal of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology and those proposed by other authors according to the stated courses of action.
Subject(s)
Meniere Disease/diagnosis , Disease Progression , Humans , Meniere Disease/therapy , Severity of Illness IndexABSTRACT
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Subject(s)
Humans , Vestibular Diseases/diagnosis , Diagnosis, Differential , SyndromeSubject(s)
Meniere Disease/surgery , Ear, Inner/surgery , Humans , Vertigo/surgery , VestibuloplastyABSTRACT
The surgical technique for vestibular neurectomy through the middle fossa approach is described. Surgical details, including the use of a new middle fossa retractor, are discussed. A variety of technical refinements have been made to improve and shorten the operation. The main surgical indication is for Meniere's disease. It has, however, also been used in other peripheral vestibular problems such as traumatic vertigo and vertigo secondary to previous ear surgery. Long-term hearing and vestibular results using this approach for Meniere's disease have been encouraging. These results, in addition to the small incidence of postoperative complications, have made the operation extremely useful.
Subject(s)
Meniere Disease/surgery , Vestibular Nerve/surgery , Humans , Methods , Neurosurgery/instrumentation , Postoperative Complications/etiology , Skull/surgery , Vertigo/surgeryABSTRACT
After a general review of the actual histopathological concept of Menière's disease, a review of the results, as concerns hearing, of the selective section of the vestibular fibers by the suboccipital approach, and of vestibular neurectomy by the middle fossa approach is made. From our personal experience in performing 247 neurectomies from November, 1969 to July, 1976 as treatment for peripheral vertigos of different etiologies, auditory function was followed-up in 78 cases of Menière's disease, with a postoperative control, between 2 and 6 1/2 years. In 51% of these cases the preoperative threshold was preserved, hearing improved in 32%, and deteriorated in 17%. Possible mechanisms by which vestibular neurectomy can favorably influence hearing are considered, with special mention of the neurovegetative theory.
