ISSN:
1434-4726
Keywords:
Isosorbide
;
Attack of vertigo
;
Menière's disease with endolymphatic hydrops
;
Cochleogram
;
Negative SP/AP
;
Isosorbid
;
Schwindelanfälle
;
Morbus Menière
;
Cochleogramm
;
Negatives SP/AP
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Zusammenfassung Aus einem Kollektiv von 24 Patienten mit refraktorischen Morbus Menière wurden 21 mit Isosorbid, einem oralen, osmotisch wirkenden Diuretikum behandelt, darunter 19 mit gutem Erfolg. Gesichert wurde die Diagnose bei fluktierender Innenohrschwerhörigkeit mittels Ableitung eines extratympanalen Cochleogramms, das bei Entwicklung eines endolymphatischen Hydrops höhere Werte des negativen SP/AP-Quotienten zeigt; der Durchschnittswert unseres Kollektivs betrug (−) 0,54 (Normbereich 0,37–0,42). Bei einer durchschnittlichen Beobachtungsperiode von 4 Monaten und 12 Tagen traten während dieser Zeit bei zwölf Patienten (63%) keine Anfälle mehr auf, bei sechs Patienten (31%) waren die Schwindelanfälle sowohl in der Häufigkeit als auch in der Schwere der Symptomatik zurückgegangen. In einem Fall blieben die Schwindelattacken unbeeinflußt, zwei weitere Patienten stehen noch unter Beobachtung. Isosorbid wurde bisher für die Therapie des Morbus Menière nicht verwendet.
Notes:
Summary According to a nationwide survery in 1977 an average of 54.7% of Menière's disease patients were unable to function normally in their daily lives. These patients mostly complained of repeated attacks of vertigo (male 40.3%, female 29.2%) (Watanabe et al. 1980). For the purpose of improving the repeated attacks of vertigo, Isosorbide as an oral hyperosmotic diuretic was first administered orally to 21 patients with Menière's disease from November 1979 to January 1981 for reducing the endolymphatic hydrops that can be presumed to be of pathogenetic importance. The electrocochleographic examinations were carried out on these patients at the same time. Usually, the SP/AP wave form in the electrocochleographic examinations appears to be more abnormal in patients with a fluctuating hearing loss or a flat hearing loss. The average of negative SP/AP in 24 patients with Menière's disease was 0.54. The indication of Isosorbide administration was determined by this particular SP/AP wave abnormality, and clinical effects of Isosorbide for the patients with Menière's disease were evaluated. In 18 patients who experienced relief, attack of vertigo did not occur in 12 (63%) and vertigo was relieved in six (31%). In two patients with long administration, hearing improvement could already be observed during the period of treatment. The electrocochleographic examinations showed a decrease in the SP/AP wave form. In two patients with short administration, hearing loss was temporarily observed in middle and low frequencies; the hearing loss later improved more than before treatment, but the SP/AP wave abnormality was still observed after treatment in these patients. In only one patient, aggravation of hearing was observed after administration, but whether it was a side effect or not, remains to be understood. The period of observation of these results was a mean value of 4 months and 12 days. The Isosorbide therapy in patients with Menière's disease is expected to replace saccus surgery.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00453541
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