MANIER’S DISEASE

Definition

Manier’s disease is an abnormal accumulations of inner ear fluid (too much circulatory fluid or inner ear) caused by malabsorption in endolymphatic sagor
blockage in the duct.

Etiology/Risk Factors

Exact cause unknown.

• virus plays a great role in the etiology but until not proven.
• Fluid and electrolyte imbalances.
• 
  Types of MANIER’S DISEASE
• Cochlear disease: It is recognized as a fluctuating, and progressive sensorineural hearing loss associated with tinnitus and Inner Ear pressure in the absence of vestibular symptoms or findings.
• Vestibular disease: It is characterized by occurrence of episodic vertigo associated with aural Ear Pressure but no cochlear symptoms.

Clinical Manifestations

• Progressive sensorineural hearing loss
• Tinnitus
• Fullness of Ear
• Nausea and vomiting
• Pressure in the ear
• Vertigo
• Ataxia.

Diagnostic Evaluation

• History collection
• Physical examination
Neurological examination
• Glycerol test
• Vestibular test (include caloric test)
• Audiometry
• Weber’s test.
• Tuning Fork Test

Management

Medical Management

• Antihistamine such as meclizine to suppress the vestibular system.
• Tranquilizers such as diazepam to help control the vertigo and Decrease Pressure
• Diuretics to Increase Urine output and Decrease Vascular Pressure
• Provide Vasodilators
• Anticholinergic catropine.

Dietary Management

• Low sodium intake in diet
• Avoidance of alcohol
• Avoidance of aspirin
• Avoid aspirin containing medications.
• Restriction of caffeine,
• Avoid nicotine intake.

Surgical Management

• Endolymphatic shunt
• Vestibular nerve section
• Labyrinthotomy
• Labyrinthectomy.

Ambulatory or Home Care

• Diuretics Use to increase Urine Output
• Vasodilators
• Antiseizure drugs
• Patient education.

Nursing Management

• Prevention of injury
• Assess for vertigo.
• Reinforce vestibular and balance therapy.
• Administer antivertigo drugs
• Encourage the patient to sit down If Feel Vertigo
• Maintaining fluid volume:
• Monitor Fluids – Intake And Output
• Monitor laboratory status
• Assess the signs of dehydration
• Avoid vestibular stimulant Like caffeine
• Administer antiemetics Drugs
• Antidiarrheal medications.
• Adjusting disability:
• Identify the patient’s strengths
• Provide information about vertigo
• Rehabilitation
• Limiting activities to Promote Self Care
• Relieving anxiety:
• Assess the level of anxiety
• Encourage patient to discuss anxiety
• Teach about stress management
• Provide comfort measures.
• Full explanation about disease condition.
• Teaching patient self care:
• Teach the patient to take medications as prescription.
• Encourage the patient to take care of the body
• Teach about coping measures to patient and family members.