耳石症

姜淑香@秋日雏菊

耳石症也叫良性阵发性位置性眩晕（benign paroxysmal positional vertigo, BPPV），是常见的外周性前庭疾病，以反复出现的位置性眩晕或头晕为特征，表现为当头部变位处于某一特定位置时出现短暂旋转性眩晕或头晕，伴有特征性眼震，根据震颤的方向才能判断出是哪一个半规管堵塞。根据眼球震颤的方向判断哪一个半规管堵塞，这样才能知道手法复位的具体方法，不同的半规管堵塞手法复位的方向是不完全一样的。正常情况下耳石是附着于耳石膜上的一种碳酸钙结晶，当一些致病因素导致耳石脱离，如耳部疾病、头部外伤、病毒性神经炎、脑供血功能不佳、中耳炎梅尼疾椎基底动脉循环障碍、体内钙离子代谢变化引起的等等，这些脱落的耳石就会在内耳内半规管里面被称作为内淋巴的液体里游动，当人体头位变化时，这些半规管亦随之发生位置变化，沉伏的耳石就会随着液体的流动而运动，从而刺激半规管毛细胞，导致机体发生强烈性眩晕，眩晕时间一般较短，数秒至数分钟，可周期性加重或缓解。病程时间长短不一。 在耳朵内有调节平衡的球囊、椭圆囊和半规管。球囊、椭贺囊结构内有碳酸钙盐结晶，形如石头，称之为耳石。通常，耳石症是由于内耳椭圆囊上碳酸钙结晶颗粒脱落下来后，进入到了内耳的半规管内所导致的。当我们的头部快速的变动时耳石颗粒脱落进了入半规管并与半规管内的淋巴液产生位移，因此刺激了前庭神经末梢感受器，然后患者就会突然出现剧烈的眩晕感。当眩晕出现后，前庭内脏神经还会反射出现恶心想吐，出汗等症状。 除此之外，导致耳石脱落的原因还有衰老退化，内耳供血不足，迷路震荡，中耳炎和前庭动脉前支阻塞等，这些症状都能引起椭圆囊的囊斑发生蜕变。一般在内耳负责平衡的半规管与椭圆囊相通，而半规管的作用是感受旋转角加速度。因此当耳石脱落以后，就会掉到半规管以及嵌顿在半规管膨大端的壶腹嵴上，患者这时如果坐起或躺下以及头位改变的时候，淋巴液的流动就会随着耳石的移动从而刺激到壶腹嵴，最终就会出现非常强烈的眩晕感。 综上所述，引起耳石症的原因有很多。我们在平时一定要注意保护好自己的耳朵，一旦发现自己有耳石症的症状，要及时治疗。对于已经患上了耳石症的患者来说，也不要太过担心，及时的用手法复位就不会再出现眩晕的感觉。再加上平日多注意护理，病情很快就会得到好转。 内耳包括耳蜗、前庭、半规管三个主要部分。耳蜗主管听觉，内耳中那个像蜗牛一样的结构就是耳蜗，它是负责感受声音的。耳朵的平衡功能是靠前庭系统来维持。跟耳蜗紧密相连的、稍微膨大的这一部分叫前庭，里面有两个特别重要的东西，一个是椭圆囊一个是球囊，它们上面都有能够感受位置变化的位觉斑。在显微镜底下可以看到位觉斑的表面有一些细小的碳酸钙的小结晶，这个就是我们所说的“耳石”。前庭后面还有三个半规管，分别是上（前）半规管、水平半规管、后半规管。半规管前端膨大的部分是壶腹嵴，里面有感受平衡的感觉细胞纤毛，半规管有五个孔和前庭相通。 正常情况下耳石也会代谢脱落，这些脱落的耳石如果被相关细胞吞噬，就不会出问题。在一些异常情况下，比如衰老退化、局部供血不足，以及其它疾病也可能导致耳石脱落。 如果没有被吞噬，脱落的耳石会顺着管口掉到半规管里，由于后半规管的位置比较靠后，所以耳石掉到后半规管的几率最大。耳石脱落以后就形成了耳石症。 内耳由骨迷路---耳蜗（让我们拥有听觉）和前庭迷路（让我们保持平衡）---构成。耳石症主要是因为内耳迷路的一些代谢性分泌物，形成结石样颗粒。患者在活动头部的时候耳石在半规管内漂浮而刺激内耳，会突然出现视物旋转，恶心呕吐，不敢睁眼等症状。　　一般比较轻的患者，通过自我调整头部的体位，症状都是可以改善的。但是有一些严重的，后期还需要人工手法复位，或者是专业的机器复位的方式来改善和治疗。治疗之后可以口服一些抗眩晕的药物，再就是注意休息。 青岛环语翻译公司业务联系电话：15588617120 联系人：姜淑香QQ邮箱：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