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JKM > Volume 44(3); 2023 > Article
Kim, Heo, Lee, Lee, Cho, Park, Ko, and Park: A Case of Chronic Meniere’s Disease Improved by Korean Medicine Treatment Including Pharmacoacupuncture of Cervical and Temporomandibular Area - A Case Report

Abstract

Meniere’s disease is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. The main pathological finding is endolymphatic hydrops, but the etiology of disease and effective treatment methods are still disputed. Recently, Cervical spine disorders(CSD) and Temporomandibular disorders(TMD) have been attracting attention as one of the causes of Meniere’s disease. A 65-year-old female Meniere patient with musculoskeletal problems in the cervical and mandible area was treated by Korean medical therapies including pharmacoacupuncture treatment. After 5 weeks of treatment, there was no meaningful change in hearing level evaluated with pure tone audiometry, but the subjective symptoms of Meniere improved significantly. Numerical rating scale (NRS) decreased from 10 to 0 for hearing loss, 10 to 3 for tinnitus and 8 to 3 for ear fullness. Also NRS of cervicalgia was reduced from 5 to 0 after treatment. The result suggests that the Korean medical therapy including pharmacoapuncture targeting CSD and TMD could be safe and effective method for patients with Meniere’s disease.

Fig. 1
Timeline of treatment
PTA, Pure Tone Audiometry; SA, Speech Audiometry ; K-THI, Korean Tinnitus Handicap Inventory; DHI, Dizziness Handicap Inventory; TMD, Temporomandibular disorders
jkm-44-3-150f1.gif
Fig. 2
Changes of NRS scores for chief complaints
TMD, Temporomandibular disorders; DGT, Dojukgangi-tang; GJT, Gami-jiwhang-tang
jkm-44-3-150f2.gif
Fig. 3
The results of pure tone audiometry and speech audiometry
X : left ear AC unmasked ] : left ear BC masked > : left ear BC unmasked Δ: right ear AC masked [ : right ear BC masked < : right ear
BC unmasked
AC, Air Conduction; BC, Bone Conduction; SA Speech Audiometry
jkm-44-3-150f3.gif
Fig. 4
Changes of K-THI and DHI score
jkm-44-3-150f4.gif
Table 1
The Composition of Herbal medicine, per Pack
Herbal name Botanical name Amount(g)
Dojukgangi-tang
生地黃 Rehmannia glutinosa 12
木通 Akebiae Caulis 8
瓜蔞仁 Trichosantes Kirilowii 6
玄蔘 Scrophularia buergeriana 6
獨活 Aralia continentalis 4
羌活 Ostericum Koreanum 4
荊芥 Schizonepeta tenuifolia 4
前胡 Anthriscs aemula 4
防風 Ledebouriella seseloides 4
白茯苓 Poriacocos Wolf 4
澤瀉 Alisma canaliculatum 4

Gami-jiwhang-tang
生地黃 Rehmannia glutinosa 16
熟地黃 Rehmanniae Radix Preparata 16
牧丹皮 Moutan Radicis Cortex 8
山茱萸 Cornus officinalis 8
澤瀉 Alisma canaliculatum 8
白茯苓 Poriacocos Wolf 8
玄蔘 Scrophularia buergeriana 8
獨活 Aralia continentalis 4
荊芥 Schizonepeta tenuifolia 4
羌活 Ostericum Koreanum 4
防風 Ledebouriella seseloides 4

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