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Guía para el diagnóstico y tratamiento de Enfermedad de Meniérè

Guía para el diagnóstico y tratamiento de Enfermedad de Meniérè

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Published by HSBCalidad

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Published by: HSBCalidad on Apr 17, 2013
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09/01/2013

 
Jd pdrd oh bkdjstkemy trdtd`koitm bo hdOicor`obdb bo @oikërî
MflotkvmJrupm quo ohdfmrd hd jdCoend bo ohdfmrdekõiEmichketm bo kitorosos
Ostds juàds präetkeds fdsdbds oi hd ovkboiekd prmvooiroem`oibdekmios pdrd oh trdtd`koitm bo hd oicor`obdb bo@oikërî)Uu prmpõsktm os ovdhudr hd ovkboiekd pufhkedbd y rodhkzdrroem`oibdekmios fdsdbds oi oh trdtd`koitm `ëbkem yqukrürjkem bo hd oicor`obdb bo @oikërî) Hms usudrkmsbkdid smi `ëbkems mtmrrkimhdrkijõhmjms( mtõhmjms(iourõhmjms( kitorikstds y `ëbkems joiordhos)Oi hd ohdfmrdekõi( robdeekõi y rovkskõi bo ostd juàdpdrtkekpdrmi hms bmetmros Lmsë Dhfortm Wrkotm Vkvord( LmsëObudrbm Juz`äi Buräi( Dbrkdid Edstrm Edrrdizd( AovkiDbmhcm Juz`äi Mrtkz( Vdcdoh Ldrd`khhm Udccõi( LmsëJdfrkoh Hmrd Cdhquëz( Homidrbm Ohàds Mrbõôoz Mrbõôoz yOvohkij [drk`d Vmlds Vmiediekm)Oitro soptko`fro boh 677> y `dym boh 677;) Uosujkoro hd rovkskõi bo ostd juàd oi oh prk`or so`ostro boh6742)Oh bmetmr Lmsë Dhfortm Wrkotm Vkvord nd skbm dsosmrpdrd Emenhodr emrpmrdtkmi oi oh dôm 677>y pdrdDbvdieob Fkmikes oi oh m 677:) Oh emstm bo ohdfmrdekõibo hd jd cuo dsu`kbm oi pdrto pmr hd DEMVH y oh tko`pmboh Uorvkekm Kitojrdbm bo Mtmrrkimhdrkijmhmjàd bohNmspktdh @khktdr Eoitrdh y oh Nmspktdh _ikvorsktdrkmEhàiked Udi Vdcdoh)Oh bmetmr Lmsë Obudrbm Juz`äi Buräi im tkoio ikijüiemichketm bo kitorës quo boehdrdr) Em`m bkroetmr bo hdrovkstd y `ko`frm bo hd luitd bkroetkvd bo hd DsmekdekõiEmhm`fkdid bo Mtmrrkimhdrkijmhmjàd( Ekrujàd bo Edfozdy Euohhm( @dxkhmcdekdh y Ostëtked Cdekdh DEMVH im ndsmstoikbm iojmekdekmios emi hd kibustrkd cdr`deëutked ikedsds em`orekdhos) Oh emstm bo ohdfmrdekõi bo hd juàd cuodsu`kbm oi pdrto pmr hd DEMVH y oh tko`pm boh UorvkekmKitojrdbm bo Mtmrrkimhdrkijmhmjàd boh Nmspktdh @khktdrEoitrdh y oh Nmspktdh _ikvorsktdrkm Ehàiked Udi Vdcdoh)Oh bmetmr Homidrbm Ohàds Mrbõôoz Mrbõôoz im tkoioikijüi emichketm bo kitorës quo boehdrdr) Oh emstm boohdfmrdekõi bo hd jd cuo dsu`kbm oi pdrto pmr hd DEMVHy oh tko`pm boh Uorvkekm Kitojrdbm boMtmrrkimhdrkijmhmjàd boh Nmspktdh @khktdr Eoitrdh y ohNmspktdh _ikvorsktdrkm Ehàiked Udi Vdcdoh)
VOEM@OIBDEKMIOU EMI FDUOOI HD EDHKBDB BO HD OSKBOIEKD
JVDBM D)
Emibkekmios pdrd hds eudhos ndy ovkboiekdemituiboito y bockiktkvd pdrd cdvmroeor hd präetked bo uidkitorvoiekõi)
JVDBM F)
Emibkekmios pdrd hds eudhos ndy ovkboiekdquo sujkoro hd präetked bo uid kitorvoiekõi)
JVDBM E)
Emibkekmios pdrd hds eudhos im ndy ovkboiekdehàiked suckekoito pdrd cdvmroeor m ovktdr hd präetked bo uidkitorvoiekõi)
JVDBM B)
Emibkekmios pdrd hds eudhos ndy ovkboiekdquo sujkoro ovktdr hd präetked bo uid kitorvoiekõi)
JVDBM O
) Emibkekmios pdrd hds eudhos ndy ovkboiekdemituiboito y bockiktkvd pdrd ovktdr hd präetked bo uidkitorvoiekõi)
EHDUKCKEDEKÕI BO HD EDHKBDBBO HD OSKBOIEKD OIEMIRVDBD
IKSOH K)
Oxpork`oitm ehàikem dhodtmrkzdbm( emidboeudbm emitrmh bo orrmros( kitorvdhms bo emickdizddeoptdfhos ym ui `otddiähksks bo edhkbdb( emi ostubkmsnm`mjëioms)
IKSOH KK)
Oxpork`oitm ehàikem dhodtmrkzdbm( skidboeudbm emitrmh bo orrmros m ski kitorvdhms bo emickdizddeoptdfhos ym ui `otddhksks emi ostubkms notormjëiomsm quo im sodi bo dhtd edhkbdb)
IKSOH KKK)
ºOxpork`oitm ehàikem emitrmhdbm im dhodtmrkzdbmºOstubkms bo edsms y emitrmhos m emnmrtosºEmnmrtos emi emitrmhos nkstõrkems m sorkos bo tko`pm.ditos y bospuës+)
IKSOH KS)
Mpkikmios bo dutmrkbdbos( emi oxporkoiekdehàiked im euditkckedbd( kicmr`os bo em`ks bo oxportms ysorkos bo edsms)Uo rodhkzõ uid füsquobd kikekdh bo hds `olmros juàds
Edhkbdb bo hd ovkboiekdOstrdtojkd bo füsquobd
Dsmekdekõi Emhm`fkdid bo Mtmrrkimhdrkijmhmjàd( Ekrujàd bo Edfozd y Euohhm( @dxkhmcdekdh y Ostëtked Cdekdh( DEMVH
Juàds Mckekdhos DEMVH
FDUDBDU OI HD OSKBOIEKD
64
 
bkspmikfhos pdrd oh bkdjiõstkem y trdtd`koitm bo hd
oicor`obdb bo @oikërî(
oi vdrkds fdsos bo bdtms( emi ohroquksktm bo quo ostuvkosoi pufhkedbds oi kijhës( ospdômhm pmrtujuës oitro hms dôms 6777 d 677> y huojm cuormioivkdbds d bkcoroitos oxportms( `ko`frms bo DEMVH(qukoios hds edhkckedrmi toikoibm oi euoitd oh bmeu`oitmDJVOO pdrd ovdhudekõi bo hd edhkbdb bo juàds( yosemjkormi hds `olmros) Uo emisuhtõ d `ko`frms boDEMVH smfro dspoetms bo hd
oicor`obdb bo @oikîrë(
quoboforàdi sor rosuohtms pmr uid juàd bo bkdjiõstkem ytrdtd`koitm) Ostd ovdhudekõi( hds jds sohoeekmidbds y hdsprojuitds rodhkzdbds cuormi oivkdbds dh UorvkekmKitojrdbm bo Mtmrrkimhdrkijmhmjàd boh Nmspktdh @khktdrEoitrdh y oh Nmspktdh _ikvorsktdrkm Ehàiked Udi Vdcdoh(pdrd su robdeekõi ckidh( y füsquobd fdsdbd oi hd ovkboiekdbo dspoetms im eufkortms pmr hds juàds bo rocoroiekd yprojuitdbms pmr hms oxportms)Ostd juàd os uid dbdptdekõi bo hd juàd pufhkedbdOvkboieo - Fdsob Mtmhdryijmhmjy( emi hds skjukoitosrocoroiekds< Diborsmi( E)1 Edroy( L )W)
Kitrdty`pdikejoitd`keki< K`pdet mi vostkfuhdr em`phdkits
y
Kitrdty`pdike joitd`keki< K`pdet mi dubkm`otry)
Autz(Z)1 Uhdttory KKK( Z) N)
Oibmhy`pndtke snuit surjoryvorsus ‘snd`surjory mr `obkedh tnordpy< K`pdet miemitrmh mc vortkjm1
 
Oibmhy`pndtke snuit surjory vorsussnd`surjory mr `obkedh tnordpy< K`pdet midubkm`otry(
y
Uurjkedh hdfyrkitnoetm`y vorsus mtnorprmeoburos< Endieo mc boerodsob vostkfuhdr em`phdkits)
 Hds füsquobds rodhkzdbds so nkekormi d trdvës bo @obhkio.4;33-677?+) U`dho( O)1 @eBmidhb( U)1 @dnd( I)1 Unmrt(U)
@didjo`oit mc @ëikîro*s bksodso ki joiordh prdetkeo<dbnoroieo tm tno _A Idtkmidh Nodhtn Uorvkeo ‘Wrmbkjyjukbohkios)
Oh vërtkjm os uid khuskõi m dhuekidekõi bo`mvk`koitm( usudh`oito rmtdekmidh( bo uim `ks`m m bohd`fkoito) Hms bkdjiõstkems ehdvo kiehuyoi iourmiktksvostkfuhdr( vërtkjm pmskekmidh pdrmxàstkem foikjim(oicor`obdb bo @oikërî( vërtkjm `kjrdômsm okisuckekoiekd vortofrmfdskhdr .4+)Hd oicor`obdb bo @oikërî cuo boserktd prk`orm oi 4>34pmr Wrmspor @oikërî( qukoi boserkfkõ hd trkdbd bonkpmdeuskd chuetudito( tkiktus y vërtkjm opksõbkem( d hd quoso dbkekmid emi croeuoiekd hd soisdekõi bo phoiktub durdh.4+)
Cuoitos fkfhkmjräckeds( fdso bo bdtmsprk`drkms y soeuibdrkms emisuhtdbmsBockikekmios
Oh Uorvkekm Idekmidh bo Udhub boh Vokim _ikbm prmbulmuids juàds pdrd por`ktkr d hms prmcoskmidhos bo hd sdhubtm`dr boekskmios emi rospoetm dh `diolm bo hms pdekoitosemi oicor`obdb bo @oikërî) Hds `otds bo hds juàds smi<ºBotoior m robuekr hms sàitm`ds burdito oh dtdquo bovërtkjm)ºVobuekr hd croeuoiekd y sovorkbdb bo hms dtdquos)ºMptk`kzdr hd dubkekõi y emitrmhdr oh tkiktus)º@dxk`kzdr hd edhkbdb bo vkbd y ndfkhkbdb pdrd dbdptdrsod hms sàitm`ds roskbudhos)Bo deuorbm emi hds juàds( hd provdhoiekd bo hd oicor`obdbbo @oikërî oi oh Vokim _ikbm os bo 4 oi 4)777 d 4 oi6)777( dcoetdibm pmr kjudh d nm`fros y `uloros( yprosoitäibmso oi ui pkem bo obdb oitro hms 67 y ?7 dôms.4+) Oh bkdjiõstkem roqukoro bo tmbms bo hms skjukoitoserktorkms<ºDh `oims bms opksmbkms bo vërtkjm quo buroi pmr hm`oims 67 `kiutms edbd uim)ºNkpmdeuskd iourmsoismrkdh emickr`dbd pmrdubkm`otràd)ºRkiktus m phoiktub durdh)Hds brmjds usdbds pdrd oh dtdquo djubm bo vërtkjm smi hdprmehmrpordzkid y hd ekidrkzkid( y pdrd prmckhdxks hdfotdnkstkid( duiquo im ndy ovkboiekd suckekoito pdrdvdhmrdr su ocoetkvkbdb) Hms bkurëtkems( smhms m oiem`fkidekõi emi hd rostrkeekõi bo sdh( smi roem`oibdbmsemi croeuoiekd porm tkoioi bdtms kiemiehusms) Hmspdekoitos rospmiboi bo cmr`d bkcoroito( hds tordpkds bofoisor prmfdbds ndstd quo oh pdekoito oieuoitro hd `äsocoetkvd) Im ndy ovkboiekd bo quo hd rostrkeekõi bo sdh(edcoàid( ikemtkid m dhemnmh dyubo d emitrmhdr hdoicor`obdb .4+)Hms pdekoitos quo bofoi sor rocorkbms dhmtmrrkimhdrkijõhmjm pdrd vdhmrdekmios smi hms quo toijdiui bkdjiõstkem bubmsm( m qukoios toijdi vërtkjmrocrdetdrkm d trdtd`koitm `ëbkem .4+)º
Joitd`kekid kitrdtk`päiked pdrd oh emitrmh bosàitm`ds vostkfuhdros .roem`oibdekõi E+)
Hd joitd`kekid kitrdtk`iked so nd usdbm pdrd `diolmbo sàitm`ds vostkfuhdros im emitrmhdbms emi trdtd`koitm`ëbkem( emi oh rkosjm bo edusdr nkpmdeuskd oi oh màbmtrdtdbm)Oh Em`ktë bo Oqukhkfrkm y dubkekõi bo hd Dedbo`kdD`orkedid bo Mtmrrkimhdrkijmhmjàd y Ekrujàd bo edfozd yeuohhm .DDM-NIU+ ehdskckeõ oh emitrmh bo rtkjm dsà<
Rrdtd`koitm
Juàds Mckekdhos DEMVH
FDUDBDU OI HD OSKBOIEKD
Oicor`obdb bo @oikërî
66
 
Ehdso D< ohk`kidekõi em`photd boh vërtkjm)Ehdso F< robueekõi bo hms opksmbkms d `oims m kjudh boh27/ bo hd croeuoiekd protrdtd`koitm)Ehdso E< robueekõi boh iü`orm bo 24 d >7/ bo croeuoiekd)Ehdso B< ed`fkm oi oh iü`orm bo >4 d 467/ bo hdcroeuoiekd protrdtd`koitm)Ehdso O< kiero`oitm `dymr boh 467/)Ehdso C< kikekdekõi bo ui trdtd`koitm soeuibdrkm bofkbm dhd porskstoiekd m roeurroiekd boh vërtkjm)Bdbm oh eursm opksõbkem bo hd oicor`obdb( hd croeuoiekdbo hms opksmbkms bo vërtkjm puobo chuetudr emi oh tko`pm(kiehuskvo oi dusoiekd bo trdtd`koitm( quo puobo emitrkfukrdh ocoetm phdeofm vkstm oi dhjuims ostubkms) Oi hmsostubkms rovksdbms td`fkëi so mfsorvõ bkcoroiekd oi hdbmsks bo hd joitd`kekid( tëeiked bo db`kikstrdekõi(prmtmemhms bo trdtd`koitm y porkmbm bo sojuk`koitm( hmeudh td`fkëi hhovd d uid vdrkdfkhkbdb bo hms rosuhtdbms)Uo rovksdrmi eudtrm ostubkms< ui oisdym ehàikem emitrmhdbm.ikvoh K+( ui oisdym ehàikem prmspoetkvm .ikvoh KK+ y bms`otddiähksks .ikvoh KS+) Hd tdsd bo rospuostd oi hms eudtrmostubkms dh trdtd`koitm emi joitd`kekid cuo `dymr boh;7/ ocoetkvd oi hmjrdr emitrmh boh vërtkjm1 ski o`fdrjm(hms ostubkms bo ikvoh K y KK td`fkëi `uostrdi uidbks`kiuekõi oi hd croeuoiekd bo opksmbkms bo vërtkjm emioh phdeofm) Ndy pmems ostubkms emitrmhdbms quo ndeoibkcàekh botor`kidr oh foiockekm bo hd kiyoeekõikitrdtk`päiked emi rospoetm dh phdeofm m dh trdtd`koitmsmhm)
Worckh bo ovkboiekdEdhkbdb bo hd ovkboiekd djrojdbd
Ikvoh KK< oxpork`oitmehàikem emitrmhdbm dhodtmrkzdbm( ski dboeudbm emitrmh boorrmros( m ski kitorvdhms bo emickdizd deoptdfhos ym ui`otddiähksks emi ostubkms notormjëioms m quo im sodi bodhtd edhkbdb)
Foiockekms
) Emitrmh boh vërtkjm( fdlm rkosjm bonkpmdeuskd)
Bosvoitdlds
Nkpmdeuskd( nkpmcuiekõi vostkfuhdrtrdisktmrkd)
Voem`oibdekõi E
) Emibkekmios pdrd hds eudhos im ndyovkboiekd ehàiked suckekoito pdrd cdvmroeor m ovktdr hdpräetked bo uid kitorvoiekõi)
Ocoetms bo hd joitd`kekid kitrdtk`päiked oi hddubkm`otràd .roem`oibdekõi E+)
Oi tmbms hms ostubkms hms rosuhtdbms bo dubkekõi bospuësbo hd joitd`kekid kitrdtk`päiked so fdsdrmi oi pdrto oi hdsjuàds bo hd DDM-NIU bo 4;;? pdrd botor`kidr oh ed`fkmoi hd dubkekõi<))ºWRD bo u`frdhos d 7(?-4-6-5 aNzºUBUEd`fkms oi hd dubkekõi skjikckedtkvms ehàiked`oito sobockikormi em`m `dymros m kjudh bo 47 bf oi oh WRD m`dymr m kjudh dh 4?/ oi UBU d hms 4>-62 `osos bospuësboh trdtd`koitm)Hd nkpmdeuskd rosuhtdito boh trdtd`koitm emi joitd`kekidkitrdtk`päiked nd skbm `àik`d em`pdrdfho emi hd tdsd bomeurroiekd bo hms pdekoitos trdtdbms emi smhm `diolm`ëbkem)Uo rovksdrmi tros ostubkms< ui oisdym ehàikem prmspoetkvm.ikvoh KK+ y bms `otddiähksks .ikvoh KS+) Hms cdetmros boemicuskõi cuormi hd bkcoroiekd oi hd bmsks bo hdjoitd`kekid( hd tëeiked bo db`kikstrdekõi( hms prmtmemhmsbo trdtd`koitm y oh pombm bo sojuk`koitm)Oh üikem ostubkm bo ikvoh KK im `mstrõ bkcoroiekdskjikckedtkvd oi hms rosuhtdbms bo dubkekõi oitro oh jrupmtrdtdbm emi joitd`kekid y oh emitrmh d hms 62 `osos bosojuk`koitm( porm hd cdhtd bo dhodtmrkzdekõi os ui sosjm)Oi hms `otddiähksks oh jrupm bo pdekoitos im trdtdbms imcuormi didhkzdbms pdrd ndeor uid em`pdrdekõiostdbàstked)
Worckh bo ovkboiekdEdhkbdb bo hd ovkboiekd djrojdbd
) Ikvoh KKK<oxpork`oitm ehàikem emitrmhdbm im dhodtmrkzdbm)
Foiockekms
) Emitrmh boh rtkjm)
Bosvoitdlds
) Nkpmdeuskd( nkpmcuiekõi vostkfuhdrtrdisktmrkd)
Voem`oibdekõi E
) Emibkekmios pdrd hds eudhos im ndyovkboiekd ehàiked suckekoito pdrd cdvmroeor m ovktdr hdpräetked bo uid kitorvoiekõi)
Ekrujàd boh snuit oibmhkicätkem vorsus ekrujàd phdeofmm trdtd`koitm `ëbkem< k`pdetm oi oh emitrmh boh rtkjm.roem`oibdekõi E+
Ostds jds smi bopoibkoitos bo quo oh pdekoito bockid uiopksmbkm bockiktkvm bo vërtkjm bo mtrms sàitm`ds y quo bëoh iü`orm oxdetm bo opksmbkms) Oi `uenms ostubkmsemitrmhdbms usdi pdekoitos quo ronüsdi hd ekrujàd em`mjrupm emitrmh( ostm puobo drju`oitdr quo im tkoiosàitm`ds sovorms pdrd ohojkr hd ekrujàd y hd rospuostdvostkfuhdr puobo sor robuekbd oi oh jrupm emitrmh)Uo mftuvkormi eudtrm drtàeuhms< bms oisdyms ehàikemsemitrmhdbms .ikvoh K+ quo em`pdrdfdi oh snuit
Juàds Mckekdhos DEMVH
FDUDBDU OI HD OSKBOIEKD
Oicor`obdb bo @oikërî
65

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