G\u0130R\u0130\u015e Membran\u00f6z koklean\u0131n hidropik distansiyonu olarak tan\u0131mlanan endolenfatik hidrops, \u00e7e\u015fitli patolojilere sekonder olarak g\u00f6zlenebilir. Endolenfatik hidrops tablosunun labirentit fiziksel trauma, Mondini displazisi, sifiliz ve otoimm\u00fcn hastal\u0131klar gibi \u00e7e\u015fitli hastal\u0131klarla birlikte ortaya \u00e7\u0131kt\u0131\u011f\u0131 bildirilmi\u015ftir(9). Bunun d\u0131\u015f\u0131nda, etyolojisinde herhangi bir sorumlu tutulacak patolojinin belirlenemedi\u011fi, endolenfatik hidropsun idiopatik ve semptomatik formu ise M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 olarak tan\u0131mlan\u0131r. M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 karakteristik olarak dalgalanmal\u0131 i\u015fitme kayb\u0131, vertigo ve tinnitusla birlikte ortaya \u00e7\u0131kar. Hastal\u0131\u011f\u0131n tan\u0131s\u0131, geleneksel olarak ataklar \u015feklinde beliren i\u015fitme ve denge yak\u0131nmalar\u0131na dayand\u0131r\u0131l\u0131r. Ancak uzun izlem olmaks\u0131z\u0131n, salt klinik bulgulara dayanarak M\u00e9ni\u00e8re has- (*) Dokuz Eyl\u00fcl T\u0131p Fak\u00fcltesi K.B.B. A.B.D. \u0130nciralt\u0131 – \u0130zmir (**) Manchester \u00dcniversitesi T\u0131p Fak\u00fcltesi K.B.B. Profes\u00f6r\u00fc, \u0130ngiltere tal\u0131\u011f\u0131 tan\u0131s\u0131n\u0131n konmas\u0131 halinde, sorunlarla kar\u015f\u0131la\u015f\u0131lmas\u0131 olas\u0131l\u0131\u011f\u0131 fazlad\u0131r. Geli\u015ftirilen \u00e7e\u015fitli odyolojik testler olmas\u0131na kar\u015f\u0131n, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131nda ataklar tarz\u0131nda ortaya \u00e7\u0131kan s\u00fcbjektif yak\u0131nmalar\u0131n tan\u0131daki \u00f6nemi hala devam etmektedir. Bu yay\u0131nda bir grup M\u00e9ni\u00e8re hastas\u0131n\u0131n klinik tablosu \u00f6zetlenerek kesin tan\u0131da semptomatolojinin de\u011feri irdelenecektir. Y\u00d6NTEM ve GERE\u00c7 Bu \u00e7al\u0131\u015fma, \u0130ngiltere’nin Manchester \u00dcniversitesi T\u0131p Fak\u00fcltesi Hastanesinin K.B.B. ve Odyoloji Departmanlar\u0131nda ger\u00e7ekle\u015ftirildi. \u00c7al\u0131\u015fmaya ba\u015flamadan \u00f6nce Manchester Sa\u011fl\u0131k Otoritesi, Klinik Ara\u015ft\u0131rma Etik Komitesinden resmi onay al\u0131nd\u0131. \u00c7al\u0131\u015fmaya kat\u0131lacak hastalar geni\u015f bir hasta grubundan se\u00e7ildi. Hastalar\u0131n \u00e7al\u0131\u015fmada yer alabilmesi i\u00e7in a\u015fa\u011f\u0131da s\u0131ralanan kriterler dikkate al\u0131nd\u0131. Bu kriterlerden ilk \u00fc\u00e7\u00fc, Amerikan Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)’nin \u0130\u015fitme ve Denge Komitesinin 1985 y\u0131l\u0131nda kabul etti\u011fi tan\u0131 kriterleridir. 51 K.B.B. ve Ba\u015f Boyun Cerrahisi Dergisi, 1998; 6 (2): 51-54 Dr. M. B\u00fclent \u015eERBET\u00c7\u0130O\u011eLU ve ark. \u00c7al\u0131\u015fmaya kat\u0131lma kriterleri 1. M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131yla uyumlu semptom kompleksinin olmas\u0131: dalgalanmalarla kendini g\u00f6steren koklear semptomlar (ayn\u0131 kulakta n\u00f6betler s\u0131ras\u0131nda e\u015fzamanl\u0131 olarak beliren ve\/veya \u015fiddetlenen i\u015fitme kayb\u0131, tinnitus ve kulakta dolgunluk) ve n\u00f6betler s\u0131ras\u0131nda ortaya \u00e7\u0131karak saatlerle ifade edilen bir zaman diliminde sonlanan ger\u00e7ek rotasyonal vertigo, 2. Saf ses odyometrisiyle belirlenen ve dalgalanmalar g\u00f6steren sensorin\u00f6ral veya mikst tip i\u015fitme kayb\u0131, 3. Yak\u0131nma, \u00f6yk\u00fc, fizik muayene ve odyolojik testlere dayal\u0131 olarak santral sinir sistemi patolojisi, vestibuler schwannoma veya ba\u015fka bir kokleovestib\u00fcler hastal\u0131\u011f\u0131n saptanmamas\u0131, 4. Klinik izlem bulgular\u0131n\u0131n test edilen kulakta M\u00e9ni\u00e8re hastal\u0131\u011f\u0131yla uyumlu olmas\u0131. 5. Test edilen kulakta iletim tipi i\u015fitme kayb\u0131 bulgular\u0131n\u0131n g\u00f6zlenmemesi, 6. Test edilen kulaktaki 0.5\/1\/2 kHz havayolu e\u015fik ortalamas\u0131n\u0131n 66 dB HL’yi a\u015fmamas\u0131, 7. Hastaya herhangi bir i\u00e7 kulak cerrahi giri\u015fiminin uygulanmam\u0131\u015f olmas\u0131, 8. Hasta ya\u015f\u0131n\u0131n presbiakuzi i\u00e7in ya\u015f s\u0131n\u0131r\u0131 olarak kabul edilen 66 ya\u015f\u0131n\u0131 a\u015fmam\u0131\u015f olmas\u0131. Hasta dosyalar\u0131ndan yukar\u0131da s\u0131ralanan kriterlere uyan on dokuz hasta se\u00e7ildi. Hastalar\u0131n minimum \u00fc\u00e7 y\u0131ll\u0131k izlemi mevcuttu. M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 iki hastada bilateral saptand\u0131. Bu iki hastan\u0131n her iki kula\u011f\u0131n\u0131n da test edilmesi sonucunda toplam yirmi bir kulak test edildi. Yirmi bir kula\u011f\u0131n on ikisi bayan, dokuzu ise erkek hastaya aitti. Test edilen kulaklar\u0131n %58’i bayanlara, %42’si ise erkeklere aitti. Hastalar\u0131n ya\u015flar\u0131 34 ile 66 y\u0131l aras\u0131nda de\u011fi\u015fmekte olup ortalama ya\u015f 52 y\u0131l idi. Ayr\u0131nt\u0131l\u0131 sorgulama sonucunda, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 d\u0131\u015f\u0131nda ba\u015fka patoloji saptanan iki hasta \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131lm\u0131\u015ft\u0131r. Test protokol\u00fc: M\u00e9ni\u00e8re hastalar\u0131na uygulanan i\u015flem ve testler a\u015fa\u011f\u0131da s\u0131ralanm\u0131\u015ft\u0131r: a. Bilateral otoskopi b. Saf ses odyometrisi c. Timpanometrik inceleme ve akustik refleks e\u015fiklerinin belirlenmesi d. Sorgulama formu: M\u00e9ni\u00e8re hastalar\u0131 i\u00e7in \u00f6zel olarak haz\u0131rlanm\u0131\u015f olan sorgulama formu, yan\u0131tlanmak \u00fczere hastalara g\u00f6nderildi. Bu formda her bir hastan\u0131n \u00e7al\u0131\u015fman\u0131n kriterlerine uygun olup olmad\u0131\u011f\u0131 ara\u015ft\u0131r\u0131ld\u0131 ve M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131n\u0131n ay\u0131r\u0131c\u0131 tan\u0131s\u0131nda gerekli olan bilgiler elde edildi. BULGULAR As\u0131l yak\u0131nma ve bu yak\u0131nman\u0131n ba\u015flang\u0131\u00e7tan itibaren ge\u00e7en s\u00fcresi. Sorgulaman\u0131n yap\u0131ld\u0131\u011f\u0131 d\u00f6nem itibar\u0131yla hastalar\u0131 as\u0131l rahats\u0131z eden yak\u0131nma, \u00fc\u00e7 s\u0131n\u0131fta toplanmaktayd\u0131. En belirgin olarak rastlanan yak\u0131nma, vertigo ve dengesizlikti (%62). Yak\u0131nmalar tablo l’de \u00f6zetlenmi\u015ftir. Tablo l Hastalar\u0131n as\u0131l yak\u0131nmalar\u0131 ve y\u00fczdeleri As\u0131l yak\u0131nman\u0131n niteli\u011fi Y\u00fczdesi Vertigo %62 \u0130\u015fitme Kayb\u0131 %28 Tinnitus %10 Episodik vertigo ve e\u015flik eden yak\u0131nmalar. Episodik ve periferik vertigo, hastalar\u0131n t\u00fcm\u00fcnde hastal\u0131\u011f\u0131n bir d\u00f6neminde mutlaka mevcuttu. Hastalardaki episodik vertigonun s\u00fcresi tablo 2’de \u00f6zetlenmi\u015ftir. Belirtildi\u011fine g\u00f6re hemen t\u00fcm hastalarda vertigo en fazla 4-5 saat s\u00fcrmekteydi. Ayr\u0131ca episodik vertigoya e\u015flik eden bulgular soru\u015fturuldu. On dokuz hastan\u0131n t\u00fcm\u00fcnde, vertigoya sekonder otonomik yak\u0131nmalardan mide bulant\u0131s\u0131 ve kusma e\u015flik etmekteydi. On be\u015f hastada ise ayr\u0131ca so\u011fuk terleme mevcuttu. Hastalara g\u00f6\u011f\u00fcste s\u0131k\u0131\u015fma hissi veya bilin\u00e7 kayb\u0131n\u0131n episodik vertigoya e\u015flik edip etmedi\u011fi soruldu, hi\u00e7bir hastada bu yak\u0131nmalar\u0131n bulunmad\u0131\u011f\u0131 anla\u015f\u0131ld\u0131. Episodik vertigo sar\u0131s\u0131nda bu yak\u0131nmalar\u0131n olmamas\u0131, denge bozuklu\u011funun etyolojisinde periferik-d\u0131\u015f\u0131 bir hastal\u0131\u011f\u0131 d\u00fc\u015f\u00fcnd\u00fcrm\u00fcyordu. Tablo 2 Hastalarda episodik vertigo ata\u011f\u0131n\u0131n s\u00fcresi ve y\u00fczdeleri Vertigo ata\u011f\u0131n\u0131n s\u00fcresi Y\u00fczdesi 3 dakika -1 saat %21 1 -3 saat %63 3 – 24 saat %16 Episodik vertigo d\u0131\u015f\u0131 zamanlardaki yak\u0131nmalar. On d\u00f6rt hastan\u0131n episodlar d\u0131\u015f\u0131nda s\u00fcrekli tinnitus yak\u0131nmas\u0131 mevcuttu (% 74). On iki hasta52 K.B.B. ve Ba\u015f Boyun Cerrahisi Dergisi, 1988; 6 (2): 51-54 Dr. M. B\u00fclent \u015eERBET\u00c7\u0130O\u011eLU ve ark. n\u0131n dengesizlik yak\u0131nmas\u0131 episodlar d\u0131\u015f\u0131nda da mevcuttu. On \u00fc\u00e7 hastada (%68) ise kulakta dolgunluk hissi episodlar d\u0131\u015f\u0131ndaki zamanlarda mevcuttu. Episodik vertigonun \u015fiddetini artt\u0131ran durumlar ve vertigo s\u0131ras\u0131nda uygulanan rahatlama y\u00f6ntemleri. Sekiz hastada (% 50) ba\u015f\u0131n hareket ettirilmesinin vertigoyu artt\u0131rd\u0131\u011f\u0131 belirlendi. Az say\u0131da hastada episodik vertigoyu tetikleyen veya \u015fiddetlendiren etkenler olarak stress, yorgunluk, a\u00e7l\u0131k, alkol, peynir ve dondurma s\u0131ralanm\u0131\u015ft\u0131. Vertigo ba\u015f g\u00f6sterdi\u011fi zaman alt\u0131 hasta uykunun yararl\u0131 oldu\u011funu (% 32), \u00fc\u00e7 hasta prochloroperazine supozituar\u0131 (% 16), bir hasta ise betahistidine hydrochloride 16 mg tabletlerini kulland\u0131\u011f\u0131n\u0131 belirtti. M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n medikal tedavisi. On alta hasta (% 84) denge problemiyle ba\u015f edebilmek i\u00e7in d\u00fczenli olarak betahistidine hydrochloride 16 mg tableti, g\u00fcnde \u00fc\u00e7 kez kullan\u0131yordu. On alt\u0131 hastadan be\u015fi vertigo ata\u011f\u0131yla kar\u015f\u0131la\u015ft\u0131\u011f\u0131 zaman ayr\u0131ca cinnarizine tableti kullanmaktayd\u0131. M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n ailesel ge\u00e7i\u015fi. On dokuz hastan\u0131n sadece be\u015fi (% 26), M\u00e9ni\u00e8re hastal\u0131\u011f\u0131na ailesinin di\u011fer bir ferdinde de rastland\u0131\u011f\u0131n\u0131 ifade etti. M\u00e9ni\u00e8re hastal\u0131\u011f\u0131na e\u015flik eden migren. On bir bayan hastan\u0131n d\u00f6rd\u00fcnde (% 36) ve sekiz erkek hastan\u0131n birinde (% 13) migren, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131na e\u015flik etmekteydi. B\u00fct\u00fcn M\u00e9ni\u00e8re hastalar\u0131nda ise bu oran % 26) \u015feklinde saptand\u0131. Aile \u00f6yk\u00fcs\u00fcnde migren hastal\u0131\u011f\u0131n\u0131n bulunmas\u0131. Onbir bayan hastan\u0131n be\u015finde (% 45) ve sekiz erkek hastan\u0131n \u00fc\u00e7\u00fcnde (% 38) aile \u00f6yk\u00fcs\u00fcnde migren hastal\u0131\u011f\u0131n\u0131n bulundu\u011fu belirtildi. Bu \u00fc\u00e7 erkek hastan\u0131n hi\u00e7birinde migrenle ili\u015fkili yak\u0131nma olmad\u0131\u011f\u0131 halde, anne veya k\u0131z karde\u015flerinde bu yak\u0131nman\u0131n bulundu\u011fu anla\u015f\u0131ld\u0131. T\u00fcm M\u00e9ni\u00e8re hastalar\u0131ndaki migren aile \u00f6yk\u00fcs\u00fc oran\u0131 ise % 42 olarak belirlendi. TARTI\u015eMA VE SONU\u00c7LAR Bu \u00e7al\u0131\u015fmaya dahil edilen hastalar\u0131n tan\u0131s\u0131, minimum 3 y\u0131l ve \u00e7o\u011funda 5 y\u0131ldan fazla olmak \u00fczere, uzun s\u00fcreli t\u0131bbi izlemlere dayanmaktad\u0131r. Dosyalar\u0131n incelenmesi ve sorgulama formunun doldurulmas\u0131 sonucunda M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n tan\u0131s\u0131nda ku\u015fku yaratanlar \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131lm\u0131\u015ft\u0131r. Bu \u00e7at\u0131\u015fmaya dahil edilenlerin tan\u0131s\u0131n\u0131n konfirme edilmesinde, hastalar\u0131n semptom ve bulgular\u0131na ek olarak odyolojik tan\u0131 ara\u00e7lar\u0131ndan da yararlan\u0131lm\u0131\u015ft\u0131r. Hastalardaki episodik vertigonun s\u00fcresi ayr\u0131ca analiz edilmi\u015ftir. Bunlardan Pfaltz ve Matefi (1978)(17), 100 olguluk serisinde, 3 dakika ile l saat aras\u0131nda episodik vertigo s\u00fcrenlerin oran\u0131m % 25, l ile 3 saat aras\u0131nda s\u00fcrenlerin oran\u0131n\u0131 % 65 ve 3 ile 24 saat aras\u0131ndakiler! de % 10 oran\u0131nda saptam\u0131\u015ft\u0131r. Bu \u00e7al\u0131\u015fmada 3 dakika ile l saat aras\u0131ndaki oran % 21, l ile 3 saat aras\u0131ndakilerin oran\u0131 % 63 ve 3 ile 24 saat aras\u0131nda s\u00fcrenlerin oran\u0131 ise % 16 olarak belirmi\u015ftir. \u00d6zetle, episodik vertigo s\u00fcrelerinin t\u00fcm olgular i\u00e7indeki oran\u0131 belirtilen yay\u0131ndaki rakamlarla uyumludur. M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131 ve migren ili\u015fkisi Migren de M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 gibi episodik seyirli ve rek\u00fcrenslerle seyreden bir hastal\u0131kt\u0131r. Migren, internal ve eksternal karotisle basiler arter sistemlerinin anormal vask\u00fcler dinamikleriyle ili\u015fkilidir. Serebral kan ak\u0131m\u0131, sistemik kan bas\u0131nc\u0131ndan ba\u011f\u0131ms\u0131z olarak karbon dioksit, oksijen ve metabolitlerin lokal d\u00fczeyine duyar\u0131l olup bu otoreg\u00fclasyon migren ata\u011f\u0131 s\u0131ras\u0131nda bozulur. Vertebrobasiler arter sisteminden kaynaklanan labirent kan ak\u0131m\u0131n\u0131n serebrum gibi otoreg\u00fclasyon yoluyla d\u00fczenlendi\u011fi kaydedilmi\u015ftir (Parker, 1995)(5). Her iki hastal\u0131kta da yak\u0131nmalar\u0131n \u015fiddeti, s\u00fcresi ve s\u0131kl\u0131\u011f\u0131 hastadan hastaya de\u011fi\u015fmektedir. Bu iki hastal\u0131ktaki primer yak\u0131nmalar\u0131n ataklar tarz\u0131nda belirmesi, stress’in olumsuz etkisi, genetik predispozisyon, labirent ve serebrumun dola\u015f\u0131m\u0131n\u0131n benzer ko\u015fullarda reg\u00fcle edilmesi ve bu iki hastal\u0131\u011f\u0131n ayn\u0131 ki\u015filerde s\u0131kl\u0131kla rastlanmas\u0131, bu hastal\u0131klar\u0131n ortak \u00f6zellikleri olup birbiriyle ili\u015fkili oldu\u011fu sonucuna var\u0131lmas\u0131na yol a\u00e7m\u0131\u015ft\u0131r. Bu ili\u015fkinin varl\u0131\u011f\u0131n\u0131n fark\u0131na var\u0131lmas\u0131 yeni de\u011filse de (M\u00e9ni\u00e8re, 1861)(2), ili\u015fkinin nedeni hakk\u0131nda hen\u00fcz bir fikir birli\u011fine var\u0131ld\u0131\u011f\u0131 s\u00f6ylenemez. M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131 tablosu ve etyoloji Paparella ve arkada\u015flar\u0131, sorgulama formuna dayal\u0131 olarak, toplam 500 M\u00e9ni\u00e8re hastas\u0131n\u0131n % 20 sinde aile \u00f6yk\u00fcs\u00fcn\u00fcn pozitifli\u011fine saptam\u0131\u015ft\u0131 (4). Ailesel ge\u00e7i\u015f oran\u0131na bu \u00e7al\u0131\u015fmada % 26 olarak rastland\u0131. Soya\u011fac\u0131 \u00e7al\u0131\u015fmalar\u0131na dayanarak, az say\u0131da da olsa, otozomal dominant ge\u00e7i\u015fli M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 olgular\u0131na rastlanm\u0131\u015ft\u0131r (Oliveria ve Braga, 1992)(3). Endolenfatik hidrops bir labirent patolojisine sekonder olarak ortaya \u00e7\u0131kabildi\u011fi gibi, ba\u015fka ek bir labirent patolojisinin saptanamad\u0131\u011f\u0131, idiopatik olgular da mevcuttur. Genel olarak kabul g\u00f6ren bir g\u00f6r\u00fc\u015fe g\u00f6re, idiopatik ve semptoma53 K.B.B. ve Ba\u015f Boyun Cerrahisi Dergisi, 1998; 6 (2): 51-54 Dr. M. B\u00fclent \u015eERBET\u00c7\u0130O\u011eLU ve ark. tik olgular\u0131 multifakt\u00f6ryel etyolojiye dayand\u0131rmak olas\u0131d\u0131r. Bu g\u00f6r\u00fc\u015fe g\u00f6re, ortak bir patolojik anatomik tablonun varl\u0131\u011f\u0131na kar\u015f\u0131n, etyolojide ba\u015fta imm\u00fcnolojik, vask\u00fcler ve genetik fakt\u00f6rler olmak \u00fczere \u00e7e\u015fitli fakt\u00f6rlerin sorumlu tutulabilece\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir. Ancak her bir olgu \u00f6zelinde \u00f6ng\u00f6r\u00fclen etyolojik fakt\u00f6rlerin as\u0131l olaydan sorumlu oldu\u011funu kan\u0131tlamak olduk\u00e7a zordur (Angelborg, 1981)(1). Bu \u00e7al\u0131\u015fmada yer alan hastalar\u0131n hemen t\u00fcm\u00fcnde, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n koklear ve vestibuler M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 s\u0131n\u0131f\u0131na sokulabilecek herhangi bir hastaya rastlanmad\u0131. Bu sonu\u00e7, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 s\u0131n\u0131f\u0131na sokulabilecek herhangi bir hastaya rastlanmad\u0131. Bu sonu\u00e7, M\u00e9ni\u00e8re hastalar\u0131nda rastlanan yak\u0131nma ve bulgular\u0131 ara\u015ft\u0131ran benzer yay\u0131nlarla (Rassekh ve Lee, 1992; Pfaltz ve Matefi, 1978) ve Amerikan Otolaringoloji ve Ba\u015f – Boyun Cerrahisi Akademisi (AAO-HNS)’nin \u0130\u015fitme ve Denge Komitesinin 1985 y\u0131l\u0131nda kabul etti\u011fi ilkelerle (Pearson ve Brackmann, 1985) uyumludur.(6,7,8) Hastalardaki episodik vertigonun zamanlamas\u0131 ve n\u00f6rovejetatif semptomlara de\u011finilecek olursa, hastalar\u0131n hemen t\u00fcm\u00fcnde rastlanan d\u00f6rt saatten az s\u00fcreli \u00e7evrenin d\u00f6nmesi tarz\u0131ndaki episodik vertigo, mide bulant\u0131s\u0131 ve kusma, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n tipik bulgular\u0131 olarak tan\u0131da olduk\u00e7a \u00f6nemli yeri olan yak\u0131nma ve bulgulard\u0131r. Bu \u015fekilde, episodik yak\u0131nma ve bulgulara dayanarak M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n tan\u0131s\u0131n\u0131n konmas\u0131 literat\u00fcrle uyumludur. \u00d6zetle, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131 tablosunda di\u011fer vestibuler hastal\u0131klardan farkl\u0131 olarak, unilateral i\u015fitme ve denge yak\u0131nmalar\u0131n\u0131n n\u00f6betler s\u0131ras\u0131nda ve e\u015fzamanl\u0131 olarak \u015fiddetlenmesi esast\u0131r, M\u00e9ni\u00e8re hastal\u0131\u011f\u0131n\u0131n kesin tan\u0131s\u0131nda-geli\u015fmi\u015f odyolojik testlerin varl\u0131\u011f\u0131na ra\u011fmen – hastan\u0131n klinik tablosunun uzun s\u00fcreli izlenmesinin \u00f6nemi hala s\u00fcrmektedir. Yaz\u0131\u015fma Adresi Dr. B\u00fclent \u015eERBET\u00c7\u0130O\u011eLU Dokuz Eyl\u00fcl T\u0131p Fak\u00fcltesi KBB ABD 35340 \u0130nciralt\u0131 – \u0130ZM\u0130R<\/p>\n
KAYNAKLAR 1- ANGELBORG, C. Role of hyperosmolar solutions in induced threshold shift. M\u00e9ni\u00e8re’s Disease. Pathogenesis, Diagnosis and Treatment, International Symposium, D\u00fcsseldorf, 159-163, 1981. 2- M\u00c9N\u0130\u00c8RE, P. Memoire sur des lesions de l’oreille \u0130nterne donnant lieu a de\u015f symptoms de congestion cerebrale apoplectiforme. Gazzette Medical Paris, 1861, 597-601. Yay\u0131n\u0131n s\u0131n\u0131rl\u0131 bir b\u00f6l\u00fcm\u00fcn\u00fcn ingilizcesi: Parker, W. Meniere’s Disease, Etiological considerations. Archives of Otolaryngoiogy, Head and Neck Surgery, Vol 121, No 4, 377-382, April 1995. 3- OLIVEIRA, C. A. ve BRAGA A.M. M\u00e9ni\u00e8re Syndrome inherited as an autosomal dominant trait. Annals of Otology, Rhinology and Laryngology, 101, 590-594,192. 4- PAPARELLA, M.M., SAJJADI, H., DA COSTA, S.S., YOON, T.H. VE LE C. T. Significance of the lateral sinus and Trautmann’s triangle in M\u00e9ni\u00e8re’s disease. M\u00e9ni\u00e8re’s Disease, Pathogenesis, Pathophysiology, Diagnosis and Treatment. Proceedings of the Second International Symposium on M\u00e9ni\u00e8re’s Disease, 1989. 5- PARKER, W. M\u00e9ni\u00e8re’s disease. Etiological considerations. Archives of Otolaryngology, Head and Neck Surgery, Vol. 121, No: 4, 377-382, April 1995. 6- PEARSON, B. W., BRACKMANN, D.E, Committee on Hearing and Equilibrium guidelines for reporting treatment results in M\u00e9ni\u00e8re’s disease: Torok revisited. Otolaryngology Head and Neck Surgery, 93, 579-581,1985. 7- PFALTZ, C. R. VE MATEFI, L. M\u00e9ni\u00e8re’s Disease – or Syndrome? A critical review of diagnose criteria. Meniere’s Disease. Pathogenesis, Diagnosis and Treatment, International Symposium, D\u00fcsseldorf, 1-10,1981. 8- RASSEKH, CRISTOPHER, H. ve HARKER, LEE, A. The prevalence of migraine in M\u00e9ni\u00e8re’s disease. Laryngoscopy. Vol. 102, No: 2, 1992. 9- RAUCH, S. D., MERCHANT, S. N. VE THEDINGER, B. A. Meniere’s Syndrome and endolymphatic hydrops. Double blind temporal bone study. Annals of Otology, Rhinology and Laryngology, 98, 873-883,1989.<\/p>\n","protected":false},"excerpt":{"rendered":"
M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131 d\u00fczenli bir seyir g\u00f6stermeyen ve s\u0131kl\u0131kla sonu\u00e7ta i\u00e7 kulakta kal\u0131c\u0131 hasara g\u00f6t\u00fcrebilen kronik ve ilerleyici bir hastal\u0131kt\u0131r. Bu hastal\u0131\u011fa tan\u0131 koymak her zaman kolay olmamaktad\u0131r. M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131n tan\u0131s\u0131n\u0131 koymakta uygulanagelen y\u00f6ntem, bu hastal\u0131kta rastlanan semptom ve bulgular\u0131 hastalarda aramakla ger\u00e7ekle\u015fir. Bu \u00e7al\u0131\u015fmada M\u00e9ni\u00e8re Hastal\u0131\u011f\u0131 tan\u0131s\u0131 konan hastalar\u0131n klinik tan\u0131mlanmakta ve de\u011ferlendirilmektedir. \u00d6zet olarak, bu \u00e7al\u0131\u015fmada al\u0131nan sonu\u00e7lar, AAO-HNS \u0130\u015fitme ve Denge Komisyonunun 1985 y\u0131l\u0131nda yay\u0131nlad\u0131\u011f\u0131 tan\u0131 kriterleriyle uyum i\u00e7indedir.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[40,25,65,111,630],"class_list":["post-3585","post","type-post","status-publish","format-standard","hentry","category-kulak-burun-bogaz","tag-calisma","tag-hasta","tag-hastalar","tag-tani","tag-yakinma"],"_links":{"self":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3585","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/comments?post=3585"}],"version-history":[{"count":1,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3585\/revisions"}],"predecessor-version":[{"id":3586,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/posts\/3585\/revisions\/3586"}],"wp:attachment":[{"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/media?parent=3585"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/categories?post=3585"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/odyova.com\/haberler\/wp-json\/wp\/v2\/tags?post=3585"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}