A Case of Chronic Meniere’s Disease Improved by Korean Medicine Treatment Including Pharmacoacupuncture of Cervical and Temporomandibular Area - A Case Report

Article information

J Korean Med. 2023;44(3):150-162

Publication date (electronic) : 2023 September 1

doi : https://doi.org/10.13048/jkm.23038

Dong-Joo Kim ¹

, Kyeong-Hwa Heo ¹

, Kyeong-Hwa Lee ¹

, Hye-Jin Lee ²

, Seung-Yeon Cho ¹^,²^,³

, Jung-Mi Park ¹^,²^,³

, Chang-Nam Ko ¹^,²^,³

, Seong-Uk Park ¹^,²^,³^,

¹Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea

²Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea

³Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea

Correspondence to: Seong-Uk Park, 892 Dongnam-ro, Gangdong-gu, Seoul, Republic of Korea, Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, Tel: +82-2-440-6217, Fax: +82-2-440-7171, E-mail: seonguk.kr@gmail.com

Received 2023 July 20; Revised 2023 August 22; Accepted 2023 August 22.

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.

Keywords: Meniere’s Disease; Pharmacoacupuncture; Temporomandibular Joint Disorders; Cervical Spine Disorders; Case Report

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

Fig. 2

Changes of NRS scores for chief complaints

TMD, Temporomandibular disorders; DGT, Dojukgangi-tang; GJT, Gami-jiwhang-tang

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

Fig. 4

Changes of K-THI and DHI score

Table 1

The Composition of Herbal medicine, per Pack

References

1. Espinosa-Sanchez J., Lopez-Escamez J.. 2016;Menière’s disease. Handbook of clinical neurology 137(257–277)

2. Rauch S.D., Merchant S.N., Thedinger B.A.. 1989;Meniere’s syndrome and endolymphatic hydrops: Double-blind temporal bone study. Annals of Otology, Rhinology & Laryngology 98(11):873–883. https://doi.org/10.1177/000348948909801108 .

3. Okuno T., Sando I.. 1987;Localization, frequency, and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in meniere’s disease. Annals of Otology, Rhinology & Laryngology 96(4):438–445. https://doi.org/10.1177/000348948709600418 .

4. Horner K.. 1993;Morphological changes associated with endolymphatic hydrops. Scanning microscopy 7(1):223–238.

5. Goebel J.A.. 2016;2015 equilibrium committee amendment to the 1995 aao-hns guidelines for the definition of meniere’s disease. Otolaryngology -Head and Neck Surgery 154(3):403–404. https://doi.org/10.1177/0194599816628524 .

6. Kim M.H., Cheon C.. 2020;Epidemiology and seasonal variation of ménière’s disease: Data from a population-based study. Audiology and Neurotology 25(4):224–230. https://doi.org/10.1159/000506921 .

7. Dieterich M.. 2008. Dizziness. A practical approach to diagnosis and management BMJ Publishing Group Ltd.

8. Kim D., Kim J., Kim C., Kim H., Kim H., Mun I.. 2010. Current otolaryngology. Head and neck surgery 1st edth ed. Seoul: Doodam. p. 645–646.

9. Jain S., Jungade S., Ranjan A., Singh P., Panicker A., Singh C., et al. 2021;Revisiting “meniere’s disease” as “cervicogenic endolymphatic hydrops” and other vestibular and cervicogenic vertigo as “spectrum of same disease”: A novel concept. Indian Journal of Otolaryngology and Head & Neck Surgery 73(174–179) https://doi.org/10.1007/s12070-020-01974-y .

10. Lee J.-H., Kim M.-W., Keum D.-H.. 2014;Two cases report on the patients with ear fullness by acupuncture therapy and scenar therapy on sternocleidomastoid muscle. Journal of Korean Medicine Rehabilitation 24(1):125–132.

11. Oh K.-C.. 2012;A clinical report on episodic vertigo with meniere’s disease treated by saam acupuncture sojangjungkyuk. The Journal of the Society of Korean Medicine Diagnostics 16(1):35–44.

12. Lee M.-S., Park Y.-G., Bae N.-Y.. 2014;A case study of a taeeumin patient with meniere’s disease treated with cheongsimyeonja-tang. Journal of Sasang Constitutional Medicine 26(3):328–337. https://doi.org/10.7730/JSCM.2014.26.3.328 .

13. Jang S.-Y., Shin H.-C.. 2011;Clinical reports of the meniere’s disease in the diagnosis of deficiency-excess. The Journal of Internal Korean Medicine 32(1):121–128.

14. Lee S-e, Kim J-h, Kim Y-b. 2004;Oriental medical treatment in meniere’s disease. Journal of Acupuncture Research 21(6):269–279.

15. Hong S.-H., Hwang C.-Y., Yoon H.-J., Park J.-Y.. 2006;One cases of meniere’s disease. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology 19(2):288–295.

16. Lee S.-Y., Kim M.-Y., Kim Y.-J., Choi W.-W., Min I.-K., Park J.-Y., et al. 2008;One case of meniere’s disease. The Journal of the Society of Stroke on Korean Medicine 9(1):40–45.

17. Kong G.S.L.Y., Oh J.H., Song J.Y., Kim S.W., Kang M.H.E.G., Lee H.C., Song W.S.. 2020;The effect of korean medicine treatment on suspected meniere’s disease with headache in a patient hospitalized at a korean medicine hospital: A case report. The Journal of Internal Korean Medicine 41(2):213–223. https://doi.org/10.22246/jikm.2020.41.2.213 .

18. Eon-ji R., Hwangbo M., Dong-chui K.. 2022;A case report of patient with meniere s disease treated with korean medicine. THE JOURNAL OF EAST - WEST MEDICINES 47(1):7–14.

19. Cho S-h. 2021;A case report of meniere’s disease treated by oryeong-san based on shanghanlun provisions. The Journal of Korean Medical Association of Clinical Sanghan-Geumgwe 13(1):99–110.

20. Ho L.H.. 2002;A clinical report on 8 constitutional acupuncture therapies for treatment one case of dissiness suggested menieres syndrome. Journal of physiology & pathology in Korean Medicine 16(5):1079–1083.

21. Jung H.-J., Ko W.-S., Yoon H.-J.. 2017;Korean medicinal review of the latest research trend on pathology of meniere’s disease. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology 30(3):103–118. https://doi.org/10.6114/jkood.2017.30.3.103 .

22. Lee K.-Y., Hong C.-H.. 2018;Recent clinical research trends on acupuncture treatment of meniere’s disease. The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology 31(3):26–38. https://doi.org/10.6114/jkood.2018.31.3.026 .

23. Jeong Y.T., Lee B.R.. 2002;The bibliographical study on the cause and etiology of vertigo (眩暈). Journal of Haehwa Medicine 11(1):163–177.

24. Jin S.. 2023;Analysis of the active compounds and therapeutic mechanisms of yijin-tang on meniere’s disease using network pharmacology (i). The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology 36(1):50–63.

25. Jin S.. 2023;Analysis of the active compounds and therapeutic mechanisms of yijin-tang on meniere’s disease using network pharmacology (ii). The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology 36(2):1–9.

26. Hearing, C. o. & Equilibrium. 1995;Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in meniere’s disease. Otolaryngology-Head and Neck Surgery 113(3):181–185. https://doi.org/10.1016/S0194-5998(95)70102-8 .

27. Goh E.-K., Lee I.-W.. 2005;Differential diagnosis of meniere’s disease. Journal of Clinical Otolaryngology Head and Neck Surgery 16(1):33–40.

28. Song J.J., Koo J.W., Kim K.S., Byun J.Y., Han G.C., Chae S.W.. 2012;The diagnosis criteria of meniere’s disease and related objective tests. Korean Journal of Otorhinolaryngology-Head and Neck Surgery 55(8):476–481.

29. Seong-Uk Park. The essence of pharmacoacupuncture Seoul: wooripub; 2020. p. 1–2. p. 13–21. p. 57–82.

30. Shim S.-Y., Park H.-J., Lee J.-M., Lee H.-S.. 2007;An overview of pain measurements. Korean Journal of Acupunct 24(2):77–97.

31. Clark J.G.. 1981;Uses and abuses of hearing loss classification. Asha 23(7):493–500.

32. Siegel L.G.. 1975;The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngologic Clinics of North America 8(2):467–473. https://doi.org/10.1016/S0030-6665(20)32783-3 .

33. Newman C.W., Jacobson G.P., Spitzer J.B.. 1996;Development of the tinnitus handicap inventory. Archives of Otolaryngology-Head & Neck Surgery 122(2):143–148. https://doi.org/10.1001/archotol.1996.01890140029007 .

34. Han G., Lee E., Lee J., Park S., Lee H., Jeon E., et al. 2004;The study of standardization for a korean adaptation of self-report measures of dizziness. J Korean Bal Soc 3(2):307–325.

35. Kim N.-J., Park H.-O., Sim C.-S., Lee C.-R., Kwon Y.-J., Lee J.-H.. 2012;The characteristics of tinnitus and hearing threshold-in workers with noise induced hearing loss from a hospital setting. Korean Journal of Occupational and Environmental Medicine 24(4):431–440.

36. Kim H.H., Wiet R.J., Battista R.A.. 2005;Trends in the diagnosis and the management of meniere’s disease: Results of a survey. Otolaryngology-Head and Neck Surgery 132(5):722–726. https://doi.org/10.1016/j.otohns.2005.01.007 .

37. Sajjadi H., Paparella M.M.. 2008;Meniere’s disease. The Lancet 372(9636):406–414.

38. Bjorne A., Berven A., Agerberg G.. 1998;Cervical signs and symptoms in patients with meniere’s disease: A controlled study. CRANIO® 16(3):194–202. https://doi.org/10.1016/S0140-6736(08)61161-7 .

39. Kempf H., Roller R.. 1993;Correlation between inner ear disorders and temporomandibular joint diseases. HNO 41(1):7–10.

40. Bjorne A., Agerberg G.. 2003;Symptom relief after treatment of temporomandibular and cervical spine disorders in patients with meniere’s disease: A three-year follow-up. CRANIO® 21(1):50–60. https://doi.org/10.1080/08869634.2003.11746232 .

41. Ku J., Jung C., Hwang J.H.. 2022;Toxicological study of su-eohyeol pharmacopuncture in an in vivo micronucleus test in sprague-dawley rats. Korean Journal of Acupuncture 39(2):54–62. https://doi.org/10.14406/acu.2022.008 .

42. Yeom S., Kim K.. Effects of ohyaksungisan and jungsongouhyul pharmacopuncture on pain reduction and nervere generation after crush injury inratsciatic nerve. The Journal of Korean Medicine Rehabilitation 2009;19(2):51–72.

43. IM J.. 2010;Neuroprotective effects of neutral pharmacopuncture for blood stasis and tangguisusangami-tang (dangguixusanjiawei-tang) in the experimental traumatic brain injury rats. Journal of Korean Medicine Rehabilitation 20(1):13–26.

44. HY K.. 2010;Effects of bee venom and cervi cornu parvum pharmacoacupuncture in monosodium iodoacetate (mia)-induced osteoarthritis rat. Journal of Korean Medicine Rehabilitation 20(1):61–77. https://doi.org/10.13048/jkm.13013 .

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