Introduction Menière disease (MD) is a disorder characterized by episodes of vertigo, sensorineural hearing loss, tinnitus and aural fullness.
Objectives To assess the effect of ventilation tube insertion (VTI) on vertiginous episodes in patients (≥ 18 years old) with MD.
Data Synthesis A systematic literature search on randomized clinical trials (RCTs), nonrandomized trials and other systematic reviews was performed. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to assess the overall certainty of evidence.Two RCTs and four nonrandomized studies were identified. Data extraction was only possible for one RCT. Results showed that the number of patients with no vertigo attacks significantly increased following active treatment (relative risk 1.52; [95% confidence interval: 1.19–1.94]). The quality of evidence was rated as low. None of the nonrandomized trials included a proper control group, which hindered data extraction and quality assessment.
Conclusion There are currently no RCTs that specifically assess the efficacy of VTI in patients with MD. Current limited data suggest a considerable positive effect on the number of vertiginous episodes in patients with MD. However, due to poor evidence, a fluctuating course and a substantial placebo-effect associated with MD-treatment, no solid conclusion(s) regarding the efficacy of VTI can be made. There is a need for high-quality RCTs.
The adenoid or pharyngeal tonsil is lymphoid tissue placed on the upper and posterior part of the nasopharynx. The adenoid is part of Waldeyer's ring (the pharyngeal, tubal, palatine and lingual tonsils as well as small collections of mucosal lined lymphatic tissue in the pharynx). The tissue is a first-line defence mediating a local and regional immune function when exposed to antigens from outside the body as well as the alimentary tract. Certain conditions can make the lymphoid tissue grow larger which results in adenoidal hyperplasia.
A SDCSS é uma doença rara (pouco estudo no Brasil) e que em primeiro aspecto, em 1998 por Minor et al.foi descrita como uma degradação da camada óssea responsável por revestir o canal semicircular superior. Está diretamente correlacionada a sintomas vestibulares e alguns pacientes podem apresentar quadros de eufonia e perda auditiva. É válido ressaltar que ainda não se conhece a etiopatologia da doença peculiaridade da síndrome em questão. Em contrapartida, há hipóteses que acreditam que o erro ocorreria durante o desenvolvimento da camada óssea que recobre o canal semicircular. Como diagnóstico, entende-se que o exame clínico é de suma importância, pelo fato dos exames estipulados como padrão ouro não serem capazes de expor alterações significativas. Quando ocorre uma suspeita, os indivíduos devem ser submetidos ao protocolo da avaliação com os testes estudados, para ser feita a confirmação da HD (hipótese diagnóstica). Por fim, entende-se que SDCSS dever ser incluída entre as causas de vertigem como de hipoacusia de transmissão e embora seja uma alteração incomum, há diversos aspectos fisiopatológicos ainda não escritos. Possui a vantagem de serem evitadas abordagens terapêuticas inapropriadas. (Minor et al, 2001) Palavras-chaves: Síndrome de Deiscência do Canal Semicircular Superior, canal semicircular superior, degradação da camada óssea, sintomas vestibulares, protocolo da avaliação, causas de vertigem, abordagens terapêuticas inapropriadas.
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