耳石癥

姜淑香@秋日雛菊

耳石癥也叫良性陣發(fā)性位置性眩暈（benign paroxysmal positional vertigo, BPPV），是常見的外周性前庭疾病，以反復(fù)出現(xiàn)的位置性眩暈或頭暈為特征，表現(xiàn)為當(dāng)頭部變位處于某一特定位置時(shí)出現(xiàn)短暫旋轉(zhuǎn)性眩暈或頭暈，伴有特征性眼震，根據(jù)震顫的方向才能判斷出是哪一個半規(guī)管堵塞。根據(jù)眼球震顫的方向判斷哪一個半規(guī)管堵塞，這樣才能知道手法復(fù)位的具體方法，不同的半規(guī)管堵塞手法復(fù)位的方向是不完全一樣的。正常情況下耳石是附著于耳石膜上的一種碳酸鈣結(jié)晶，當(dāng)一些致病因素導(dǎo)致耳石脫離，如耳部疾病、頭部外傷、病毒性神經(jīng)炎、腦供血功能不佳、中耳炎梅尼疾椎基底動脈循環(huán)障礙、體內(nèi)鈣離子代謝變化引起的等等，這些脫落的耳石就會在內(nèi)耳內(nèi)半規(guī)管里面被稱作為內(nèi)淋巴的液體里游動，當(dāng)人體頭位變化時(shí)，這些半規(guī)管亦隨之發(fā)生位置變化，沉伏的耳石就會隨著液體的流動而運(yùn)動，從而刺激半規(guī)管毛細(xì)胞，導(dǎo)致機(jī)體發(fā)生強(qiáng)烈性眩暈，眩暈時(shí)間一般較短，數(shù)秒至數(shù)分鐘，可周期性加重或緩解。病程時(shí)間長短不一。 在耳朵內(nèi)有調(diào)節(jié)平衡的球囊、橢圓囊和半規(guī)管。球囊、橢賀囊結(jié)構(gòu)內(nèi)有碳酸鈣鹽結(jié)晶，形如石頭，稱之為耳石。通常，耳石癥是由于內(nèi)耳橢圓囊上碳酸鈣結(jié)晶顆粒脫落下來后，進(jìn)入到了內(nèi)耳的半規(guī)管內(nèi)所導(dǎo)致的。當(dāng)我們的頭部快速的變動時(shí)耳石顆粒脫落進(jìn)了入半規(guī)管并與半規(guī)管內(nèi)的淋巴液產(chǎn)生位移，因此刺激了前庭神經(jīng)末梢感受器，然后患者就會突然出現(xiàn)劇烈的眩暈感。當(dāng)眩暈出現(xiàn)后，前庭內(nèi)臟神經(jīng)還會反射出現(xiàn)惡心想吐，出汗等癥狀。 除此之外，導(dǎo)致耳石脫落的原因還有衰老退化，內(nèi)耳供血不足，迷路震蕩，中耳炎和前庭動脈前支阻塞等，這些癥狀都能引起橢圓囊的囊斑發(fā)生蛻變。一般在內(nèi)耳負(fù)責(zé)平衡的半規(guī)管與橢圓囊相通，而半規(guī)管的作用是感受旋轉(zhuǎn)角加速度。因此當(dāng)耳石脫落以后，就會掉到半規(guī)管以及嵌頓在半規(guī)管膨大端的壺腹嵴上，患者這時(shí)如果坐起或躺下以及頭位改變的時(shí)候，淋巴液的流動就會隨著耳石的移動從而刺激到壺腹嵴，最終就會出現(xiàn)非常強(qiáng)烈的眩暈感。 綜上所述，引起耳石癥的原因有很多。我們在平時(shí)一定要注意保護(hù)好自己的耳朵，一旦發(fā)現(xiàn)自己有耳石癥的癥狀，要及時(shí)治療。對于已經(jīng)患上了耳石癥的患者來說，也不要太過擔(dān)心，及時(shí)的用手法復(fù)位就不會再出現(xiàn)眩暈的感覺。再加上平日多注意護(hù)理，病情很快就會得到好轉(zhuǎn)。 內(nèi)耳包括耳蝸、前庭、半規(guī)管三個主要部分。耳蝸主管聽覺，內(nèi)耳中那個像蝸牛一樣的結(jié)構(gòu)就是耳蝸，它是負(fù)責(zé)感受聲音的。耳朵的平衡功能是靠前庭系統(tǒng)來維持。跟耳蝸緊密相連的、稍微膨大的這一部分叫前庭，里面有兩個特別重要的東西，一個是橢圓囊一個是球囊，它們上面都有能夠感受位置變化的位覺斑。在顯微鏡底下可以看到位覺斑的表面有一些細(xì)小的碳酸鈣的小結(jié)晶，這個就是我們所說的“耳石”。前庭后面還有三個半規(guī)管，分別是上（前）半規(guī)管、水平半規(guī)管、后半規(guī)管。半規(guī)管前端膨大的部分是壺腹嵴，里面有感受平衡的感覺細(xì)胞纖毛，半規(guī)管有五個孔和前庭相通。 正常情況下耳石也會代謝脫落，這些脫落的耳石如果被相關(guān)細(xì)胞吞噬，就不會出問題。在一些異常情況下，比如衰老退化、局部供血不足，以及其它疾病也可能導(dǎo)致耳石脫落。 如果沒有被吞噬，脫落的耳石會順著管口掉到半規(guī)管里，由于后半規(guī)管的位置比較靠后，所以耳石掉到后半規(guī)管的幾率最大。耳石脫落以后就形成了耳石癥。 內(nèi)耳由骨迷路---耳蝸（讓我們擁有聽覺）和前庭迷路（讓我們保持平衡）---構(gòu)成。耳石癥主要是因?yàn)閮?nèi)耳迷路的一些代謝性分泌物，形成結(jié)石樣顆粒?；颊咴诨顒宇^部的時(shí)候耳石在半規(guī)管內(nèi)漂浮而刺激內(nèi)耳，會突然出現(xiàn)視物旋轉(zhuǎn)，惡心嘔吐，不敢睜眼等癥狀。　　一般比較輕的患者，通過自我調(diào)整頭部的體位，癥狀都是可以改善的。但是有一些嚴(yán)重的，后期還需要人工手法復(fù)位，或者是專業(yè)的機(jī)器復(fù)位的方式來改善和治療。治療之后可以口服一些抗眩暈的藥物，再就是注意休息。 青島環(huán)語翻譯公司業(yè)務(wù)聯(lián)系電話：15588617120 聯(lián)系人：姜淑香QQ郵箱：634363114@qq.com微信：qq634363114 OtolithiasisOtolithiasis also known as benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disease characterized by recurrent positional vertigo and dizziness, and manifests transient rotational vertigo or dizziness when the head is in a specific position, accompanied with specific nystagmus. By the direction of the nystagmus, which semicircular canal is blocked can be determined or judged, and based on this, the specific method of manual otolith reduction can be adopted, for the different semicircular canal blockages have to take a different direction of reduction. Under normal circumstances, the otolith is a kind of calcium carbonate crystal attached to otolithic membranes, off which they fall as a result of a number of pathogenic factors, ear disorders, head injury, viral neuritis, blood shortage to brain, otitis media meni disease vertebrobasilar artery circulation disorder, changes in calcium metabolism in the body and so on. The displaced otolith will swim in a fluid called the endolymph in the semicircular canals of the inner ear, when the human head changes the positions, the semicircular canal changes its position too and the displaced otolith is also flowing and moving along with the fluid, such motion as thus stimulates hair cells of semicircular canals and causes the body dramatic vertigo with a short period of it about a few seconds to several minutes, which can be aggravated or alleviated periodicity. The duration of the disease varies. In the ear, there are balloon, ellipse sac and semicircular canals that regulate balance. And in the structure of balloon and ellipse sac there are calcium carbonate crystals, which are like stones and called otolith. In general, otolith is caused by crystal of calcium carbonate falling off the oval sac of the inner ear and entering the semicircular canals of the inner ear. When our head moves rapidly, the displaced otolith particles are followed the action to enter into the semicircular canals and displace the lymphatic fluid in the semicircular canals, thus stimulating vestibular nerve endings, and the patient suddenly experiences a sever sensation of vertigo. When vertigo occurs, the vestibular visceral nerve will also respond to nausea, vomiting, sweating and other symptoms. In addition, there are another reasons for the diplaced otolith that is degeneration of aging, insufficient blood supply to the inner ear, labyrinth concussion, otitis media and obstruction of the anterior vestibular artery, etc. These symptoms can cause the transformation of the plaques of the elliptical capsule. In general, the semicircular canal in charge of balance in the inner ear is connected to the elliptical sac, and the semicircular canal’s function is to sense rotational angular acceleration. Therefore, after the otolith falls off, it will fall into the semicircular canals and becomes trapped on the ampulla cristae at the enlarged end of the semicircular canal. At this time, if the patient sits or lies down and the head position changes, the flow of lymphatic fluid will stimulate the ampulla cristae with the movement of the otolith, and eventually a very strong sense of vertigo will occur. To sum up, there are many reasons for otoliths. We should pay attention to protect our ears at ordinary times, once we find that we have symptoms of such kinds, we should treat them in time. For the patients who have suffered from otoliths, don’t worry too much about it, the feeling of dizziness will no longer appear by using manual reduction in time. Coupled with more attention to daily nursing, the condition will soon get better. The inner ear includes cochlea, vestibule and semicircular canal. Among these, the cochlea is responsible for hearing, and the snail-like structure in the inner ear is called the cochlea, which is responsible for sensing sound as well. The balance function of the ear is maintained by the vestibular system. Attached to the cochlea is a slightly enlarged part called the vestibule, inside which contains two particularly important things, an elliptical sac and a balloon, on both of which have spot that can sense changes in position. Under the microscope, you can see tiny crystals of calcium carbonate on the surface of the spot, which is called “otolith”. Behind the vestibule, there are also three semicircular canals, which are superior (anterior) semicircular canal, horizontal semicircular canal and posterior semicircular canal. The enlarged anterior part of the semicircular canal is the ampulla cristae, which contains the balance sensory cilia and the semicircular canal has five holes that communicate with the vestibule. Under normal circumstances, otoliths can also metabolize and fall off normally. If the otoliths are swallowed by the relevant cells, there will be no problem. But, otoliths can also fall out under abnormal conditions, such as, degeneration of aging, inadequate local blood-supply, and other diseases. If the otolith isn’t swallowed, the missing one will fall down the canal opening into the semicircular canal, which is most likely to fall into the posterior semicircular canal because of its position in behind. Otoliths are formed when they otoliths fall off. The inner ear consists of a bony labyrinth that has to parts: the cochlea, which enable us to hear, and the vestibular labyrinth, which enables us to keep our balance. Otoliths are mainly due to some metabolic secretions of the labyrinth of the inner ear, the formation of stone-like particles. The patient who moves the head forces the otoliths in the semicircular canal to float and stimulate the inner ear, and suddenly appears rotating vision, nausea and vomiting, dare not open eyes and other symptoms. Light symptoms of patients , through self-adjustment of the head position, generally can be improved. But patients with sever symptoms later still need artificial manual reduction or professional machine reduction to improve and further treatment. After treatment, some anti-vertigo drugs can be taken orally, and then pay attention to rest. Qingdao Global language translation CompanyBusiness Call: 15588617120Contact person: Jiang ShuxiangQQ E-mail: 634363114@qq.comWeChat:qq634363114