Ménière ' s Disease

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Nadir YILDIRIM
Kütahya Sağlık Bilimleri Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları ABD, Kütahya, Türkiye
Article Language: TR
Bilim ve bilime dayalı alanlardan olan modern tıp, sürekli bir dönüşüm ve gelişim içindedir. Temel bilimlerdeki gelişmelerin moleküler biyoloji ve genetik gibi birkaç alan dışında artık daha yavaş olmasına karşın tıp teknolojisindeki ilerlemeler bazen baş döndürücü bir hızda artarak devam etmektedir. Ancak, bu genel eğilimin tersine; ''idiyopatik'' olarak damgalanan hastalıkların doğal olarak araştırmacıların ilgisini daha çok çektiğini ve buna paralel olarak bu hastalıkları tanımlayıcı çalışma ve buluşların, geometrik olarak artış gösterdiğini izlemekteyiz. Bu bağlamda, veri tabanlarında ''Ménière hastalığı'' anahtar kelimesi ile karşınıza çıkan makalelerin sayısının, ondan çok daha sık görülen ''kronik otitis media'' ile benzer olduğunu görmekteyiz.

Ménière hastalığı olarak tanımlanmış olan iç kulak bozukluğunda, Monseiur Docteur Ménière'in tanımlamasından 1,5 yüzyıl sonra geldiğimiz nokta artık; ''vertigo atakları ve eşlik eden diğer odyovestibüler bulgularla kendini gösteren klinik tablonun, tek bir hastalığın tezahürü olup olmadığı'' sorusudur. Aslına bakarsanız Dr. Ménière'in ilk tanımladığı olgu da ilgili bölümde de değinildiği üzere, bugün bizim ''Ménière hastalığı'' olarak bildiğimiz patoloji değil, bir ''sekonder endolenf hidropsu'' olgusudur. Hastalık konusundaki yapılan her yeni keşif bazı sorulara yanıt vermekle birlikte bazen de beraberinde daha çok sayıda başka sorular getirmektedir. Bilimsel gelişme ve ilerleme de çoğunlukla bu devridaim ile olmaktadır. Bu sürecin sonucu olarak çok da uzak olmayan bir gelecekte muhtemelen Ménière hastalığının alt tiplerinin artık daha geniş bir kabul gördüğüne ve belki bazılarının başka başlıklar altında sınıflandırıldığına tanık olacağız.

Bu kitapta bazı konuların içeriklerinin çakıştığını, bazı bilgilerde ister istemez tekrara düşüldüğünü, hatta aynı konuda kısmen de olsa farklı görüş ve teorilerin dillendirildiğini de göreceksiniz. Bu, eğer öyle değerlendirilecekse, konu bütünlüğünün bozulmaması açısından göze alınmış bir kusurdur. Ancak, demografik veriler gibi daha az yoruma açık konularda birbiri ile örtüşmeyen bilgiler için bir ''orta yol bulma'' gayÖN SÖZ PREFACE reti de harcanmıştır. Çoklu gözden geçirme ve düzeltmelere karşın gözünüze çarpacak yazım ve dilbilgisi hataları için şimdiden hoşgörünüze sığınıyoruz.

İzleyen bölümlerdeki derlemeleri yapan yazarlar, konularında uzman, çoğu ilgili konularda çalışmalar yapmış hekimler ve akademisyenlerdir. Ben tümüne emek ve katkıları için ayrı ayrı çok teşekkür ediyorum. Bu kitabın size ulaşmasında sabır ve özenle çalışan başta yazı işlerinden Sn. Beydanur AHİ ve dizgi servisi personeli olmak üzere Türkiye Klinikleri çalışanları da özel bir teşekkürü hak etmektedirler.

''Ménière Hastalığı'' başlıklı kitabın tüm okurlara yararlı olması yanında ''bu konuda daha ileri çalışmalara ihtiyaç vardır'' cümlesiyle biten her bir alt bölümün, konuya ilgili ve araştırma yapmaya hevesli özellikle genç araştırmacıları teşvik etmesi, en içten dilek ve beklentilerimizdendir.

Prof. Dr. Nadir YILDIRIM
Editör
Ağustos 2023, Kütahya
Science and modern medicine that is based on science are in constant evolution and progress. Although the advances made in the basic sciences, apart from selected fields such as molecular biology and genetics, has relatively slowed down; developments made in the medical technologies keep growing at a breakneck speed. However, contrary to this trend, the diseases branded as ''idiopathic'' attract the interest of the researchers more than the others and the number of descriptive studies and discoveries in these fields are exponentially multiplying parallel to this development. Within this context, the number of articles one may come across in databases with the keyword ''Ménière's disease'' is almost as many as with ''chronic otitis media'' which is a much more prevalent disease.

The point we arrived in the Ménière''s disease 1,5 centuries after Monsieur Docteur Ménière's description is the question of ''whether the clinical entities manifested with vertiginous attacks and accompanying symptoms are variants of a single pathology''. As the matter of fact, the first case that Dr. Ménière described was not the pathological tableau which we now know as ''Ménière's disease'' it was rather a ''secondary endolymphatic hydrops'' case as we will read in the relevant chapter. Every revelation on the disease has brought more new questions along with than the answers it provided. Scientific progress mostly occurs through this revolving anyway. As a result of this process, we most likely witness that the subgroups of the ''Ménière's disease'' would be more widely accepted and some of those would be classified under different headings in not so remote future.

The readers would see some unavoidable overlaps in the coverage of the various aspects of the disease in different chapters of this book, you even would see that somewhat differing views and theories were spelled out on the same subject. These are handicaps, if one may call them so, which were intentionally permitted for the sake of the chapters' integrity. Nevertheless, an effort also has been made to find a ''middle way'' for the divergent information on the subjects such as demographic data, PREFACE ÖN SÖZ which are less suitable for interpretations. Despite multiple reviews, you still might see some grammatical and spelling errors, for which we do apologize in advance.

The authors of the following review chapters are physicians and academicians who have published studies and/or expertise in their respective topics. I sincerely convey my appreciations to each of them for their efforts and contributions. The personnel of the Türkiye Klinikleri especially Ms. Beydanur AHİ from the editorial service and typesetters deserve a special thank for their patient and meticulous work in the completion of this book.

We sincerely wish and expect that this book titled ''Ménière's Disease'' would be beneficial to the readers and that each sub-section finishing with the phrase of ''further studies are required in this field'' would stimulate enthusiastic researchers, especially the young ones, who have interest in the subject.

Prof. Dr. Nadir YILDIRIM
Editor
August 2023, Kütahya

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