Meniere hastalarında “koklear iletim tipi iflitme kaybı”

Amaç: Endolenfatik hidropsun deneysel modellerindeki fizyolojik çalışmalar Meniere hastalığında ovalve yuvarlak pencere etrafında basınç değişimleri ortaya çıktığını göstermektedir. Bazı hastalarda Meniere atakları sırasında iletim tipi işitme kaybının gözlenmesi ilginç bir bulgudur. Bu hastaların yakındanişitsel takipleri ataklar sırasında ortaya çıkan hidrodinamik değişimleri ve iç kulak mikromekaniğini dahaiyi anlamamıza yardımcı olabilecektir.Hastalar ve Yöntemler: Bu çalışma için 84 Meniere hastası incelemeye alındı. Meniere hastalığının ortalama süresi altıay ile 22 yıl arasında dağılım göstermekteydi ort.6.2 yıl . Hastaların üç yıl süreyle longitudinal takipleri planlandı. Kemik ve hava yolu eşiklerinin ortalamaları çıkarıldı ve eşikler arasındaki farklar hesaplandı.Bulgular: Yirmi dört hastada %28.4 en az bir frekansta hava-kemik yolu açıklığı gözlendi. Hava-kemik yolu aralığı analizinde sırasıyla 0.5, 1, 2, and 4kHz frekanslarda 18.3, 11.8, 2.8 ve 11.1 dB fark görüldü. Ortalama hava-kemik yolu aralığı 11.5 dB idi.En büyük fark 0.5 kHz, en düşük fark 2 kHz’de idi.Sonuç: Meniere hastalığında düşük frekans işitmekaybı görülebilir ve bu durum orta kulak patolojisiyle ilgili değildir. Bu durumun yakın dönemde vertigo atağı geçirmiş olan hastalarda sıkça izlenmesistapes vibratuar mekaniğinin bozulması ile açıklanabilir

Anahtar Kelimeler:

Odyometri, endolenfatik hidrops, işitmekaybı, iletim tipi, Meniere hastalığı/fizyopatoloji

“Cochlear conductive hearing loss” in patients with Meniere’s disease

Objectives: Physiological studies with experimental models of endolymphatic hydrops in Meniere's disease demonstrate some pressure changes at the level of round and oval window. Interestingly, conductive type hearing loss was observed in some patients during Meniere episodes. A close auditory follow-up of these patients may provide a better understanding of hydrodynamic changes of the hydrops and micromechanics of the inner ear. Patients and Methods: Eighty-four patients mean age 34.3 years; range 17 to 77 years with Meniere’s disease were enrolled in the study. Duration of Meniere symptoms ranged between six months to 22 years mean 6.2 years . Longitudinal follow-up of patients was planned for three years. Bone and air conduction thresholds were averaged and the differences between the thresholds were calculated. Results: Twenty-four patients 28.4% demonstrated air-bone gap at least at one frequency, the differences being 18.3, 11.8, 2.8, and 11.1 dB at 0.5, 1, 2, and 4 kHz, respectively. The average air-bone gap was 11.5 dB. The difference was the greatest at 0.5 kHz and the least at 2 kHz. Conclusion: Low-frequency conductive hearing loss may be detected in Meniere’s disease, which is apparently not indicative of middle ear pathology. High incidence of conductive involvement in patients who have had a recent episode of vertigo may indicate a distortion of vibratory movement of the stapes.

Keywords:

Audiometry, endolymphatic hydrops, hearing loss, conductive, Meniere’s disease/physiopathology,

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