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Menier

QuestionAnswer
Meniere’s disease intermittent but progressive deterioration of hearing & balance
Key features tinnitus, one-sided sensorineural hearing loss, vertigo
Pathology overproduction or decreased reabsorption of endolymphatic fluid; results in distortion of the inner-canal system
Distortion effects decreased hearing from dilation of cochlear duct, vertigo from damage to vestibular system
S/S of “attack” intense vertigo lasting 3-4 hours, nausea, vomiting, nystagmus, severe headache
Non-surgical/Nursing education make slow head movements (prevents increase in vertigo), NaCl/fluid restriction (reduces amt. of endolymphatic fluid, quit smoking (reduce vessel constriction
Drug therapy goal control vertigo & vomiting, restore normal balance
Mild diuretics Decrease endolymph volume
Nicotinic acid Vasodilating effects
Antihistamines reduce severity/stop acute attach
Antiemetic control N/V
Benzos calms pt, controls vertigo & N/V, allows quiet rest during attack
Surgical management last resort; indicated when medical therapy is ineffective & significant hearing loss
Labyrinthectomy radical resection of vestibular nerve/total removal of labyrinth; foot of stapes is moved aside and labyrinth is removed
Endolymphatic decompression early in course of disease; drainage of endolymphatic sac w/ shunt placement
Endolymphatic decompression (POST OP) reassure pt that post-op vertigo is temporary due to movement of vestibular structures
No SMOKING smoking results in constriction of blood vessels
Created by: jlee12406
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