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Die chirurgische Therapie des M. Menière

Historische Entwicklung und heutiger Stand

Surgical therapy in Menière’s disease

Historical development and today’s state of the art

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Zusammenfassung

Gut 40 Jahre nach der Erstbeschreibung der typischen Symptome durch P. Menière 1861 wurden die ersten ohrchirurgischen Verfahren zur Therapie des M. Menière angewandt. Im 20. Jh. etablierten sich die heute noch gängigen, bei konservativ nicht beherrschbarem M. Menière durchgeführten Op.-Methoden, v. a. die Sakkotomie und unterschiedliche Formen der Vestibularis-Neurektomie, aber auch die toxische Labyrinthausschaltung durch transtympanale Gentamicin-Applikation. Trotz guter Erfolge all dieser Therapien ist der zugrunde liegende Pathomechanismus bis heute nicht geklärt. Seit der Entdeckung des als pathognomonisch anerkannten Endolymphhydrops durch Hallpike u. Cairns 1938 fanden sich zwar Hinweise auf eine infektiöse, allergische und autoimmunologische (Ko)pathogenese, jedoch erklären diese nicht alle Menière-Fälle. Ziel dieser Arbeit ist es, den aktuellen Stand der Wissenschaft, Diagnostik und Therapie des M. Menière mit Betonung der chirurgischen Ansätze darzulegen.

Abstract

After P. Menière’s first description of the typical symptoms in 1861 it took more than 40 years before the first otosurgical procedures were performed to cure Menière’s disease. Various surgical methods were established during the twentieth century, which still are employed in the treatment of intractable Menière’s disease, especially saccotomy and vestibular neurectomy but also intoxication of the labyrinth by intratympanic application of gentamicin. Despite the good results of such therapeutic regimens the basic pathological mechanism is still not fully understood. Since the description of an endolymphatic hydrops by Hallpike und Cairns in 1938 as a typical feature, there have been some observations of a possible infectious, allergic and autoimmunological (co)pathogenesis without enough proof to explain the disease in every case. This article aims to present the current scientific data, diagnostics and therapy of Menière’s disease with special emphasis on surgical treatment options.

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  1. Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf-, Hals- und plastische Gesichtschirurgie, Klinikum Darmstadt, Heidelberger Landstraße 379, 64297, Darmstadt - Eberstadt, Deutschland

    G. Baier & I. Ott

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Correspondence to G. Baier.

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Baier, G., Ott, I. Die chirurgische Therapie des M. Menière. HNO 56, 553–566 (2008). https://doi.org/10.1007/s00106-008-1734-x

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