Concomitant Obstructive Sleep Apnoea in Patients with Meniere's Disease: A Case Report and Literature Review.

IF 0.4 Q4 OTORHINOLARYNGOLOGY Case Reports in Otolaryngology Pub Date : 2021-03-23 eCollection Date: 2021-01-01 DOI:10.1155/2021/5592611
Wong Kein Low, Esther Jiayi Lim
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Abstract

Meniere's disease (MD) is a condition characterised by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo. The disabling vertigo symptoms can be controlled in most patients by lifestyle changes and medications such as diuretics. Should standard medical therapy fail, the patient may require surgery in order to control the disease, but such surgical procedures can be functionally destructive. Obstructive sleep apnoea syndrome (OSAS) is common, especially in people who are grossly overweight. Up to 15% of patients with MD may have concomitant OSA. Unless the OSA is well controlled, such patients may continue to experience MD symptoms despite receiving adequate standard medical therapy for MD. Moreover, MD patients may experience insomnia as a result of vertigo and/or tinnitus where sedatives are indicated. The use of sedatives with muscle relaxant properties may inadvertently further aggravate OSA resulting in a vicious cycle of symptoms. Symptoms suggestive of concomitant OSA must be proactively sought as these patients do not necessarily exhibit the obvious phenotypic features of OSA. This is especially so in Asians where OSAS is commonly observed in people who are not overly obese. We report a case of a female patient who presented with recalcitrant MD disease and was later found to have concomitant OSA. The relevant literature will be reviewed, and learning points will be discussed from the perspective of the otologist/neurotologist. The clinician must always be mindful of the existence of concomitant "silent" OSAS as this impacts the management of patients with MD.

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梅尼埃病患者伴发阻塞性睡眠呼吸暂停1例报告及文献复习
梅尼埃氏病(MD)是一种以波动和进行性听力丧失、听觉充盈、耳鸣和间歇性眩晕为特征的疾病。大多数患者的致残性眩晕症状可以通过改变生活方式和服用利尿剂等药物来控制。如果标准的药物治疗失败,患者可能需要手术来控制疾病,但这种手术可能会对功能造成破坏。阻塞性睡眠呼吸暂停综合征(OSAS)很常见,尤其是在严重超重的人群中。高达15%的MD患者可能伴有OSA。除非OSA得到很好的控制,否则尽管接受了适当的MD标准药物治疗,这些患者仍可能继续出现MD症状。此外,MD患者可能因眩晕和/或耳鸣而失眠,这时需要使用镇静剂。使用具有肌肉松弛特性的镇静剂可能会在无意中进一步加重OSA,导致症状的恶性循环。由于这些患者不一定表现出OSA的明显表型特征,因此必须积极寻找提示合并OSA的症状。这在亚洲尤其如此,在亚洲,OSAS通常出现在不过度肥胖的人群中。我们报告一例女性患者谁提出顽固性MD疾病,后来发现有合并阻塞性睡眠呼吸暂停。回顾相关文献,并从耳科/神经科医生的角度讨论学习要点。临床医生必须时刻注意伴随的“隐性”OSAS的存在,因为这会影响MD患者的管理。
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来源期刊
Case Reports in Otolaryngology
Case Reports in Otolaryngology OTORHINOLARYNGOLOGY-
自引率
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发文量
20
审稿时长
13 weeks
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