关于在Meniere病中可疑自主失调的历史疗法
Diane Jung1, Dianela Perdomo1, Bryan K Ward2
1Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
The Laryngoscope
|August 16, 2023
概括
猜测自主神经系统导致梅尼尔病的猜测导致了侵入性手术和诸如贝塔希斯 (betahistine) 等治疗. 目前的证据不支持梅尼尔氏病的交感过度激活,需要对这些做法进行重新评估.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 神经学 神经学
- 医学史 医学史 医学史
背景情况:
- 自主神经系统在历史上与梅尼尔氏病 (MD) 有关,这是由于一个投机性的假设.
- 临床医生认为,交感性失调导致MD的和听力损失,通过血管和耳营养不良.
研究的目的:
- 根据自主神经系统假设,审查针对梅尼尔病的侵袭性治疗方法的历史采用情况.
- 批判性地评估支持手术共感切除和贝塔希斯治疗MD的证据.
主要方法:
- 进行了1860-2022年文学叙事审查.
- 搜索包括与梅尼尔氏病,自主神经系统,交感切除术和贝塔希斯相关的术语.
- 相关出版物被选中,并由所有作者讨论.
主要成果:
- 在19世纪和20世纪,自主神经系统假设导致了对MD的交感切除术的执行.
- 在20世纪70年代,贝塔希斯作为外科手术的医疗替代品出现.
- 这些干预措施的基础是有限的动物实验和孤立的临床观察.
结论:
- 过早接受一个合理的假设导致不必要的外科手术和医疗治疗MD.
- 缺乏证据支持同情性过度激活是梅尼尔氏病的原因.
- 严格评估MD当前治疗实践的有效性至关重要.
相关概念视频
Disorders of the Autonomic Nervous System
703
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's...
Raynaud's disease, also known as Raynaud's...
703
Equilibrium and Balance
4.8K
The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...
4.8K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
463
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
463
Mitral Regurgitation III: Medical Management
18
Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
18
Parkinson's Disease: Treatment
299
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
299
Neural Regulation of Blood Pressure
2.9K
The neural regulation of blood pressure involves intricate interactions between the autonomic nervous system (ANS) and cardiovascular system, ensuring adequate perfusion of tissues. This regulation primarily occurs through baroreceptor and chemoreceptor reflexes, involving both short-term and long-term mechanisms.
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
2.9K


