스크랩 내이전정(內耳前庭 : the vestibule of the inner ear)이란?

[황문철]

내이전정(內耳前庭 : the vestibule of the inner ear)이란?

(일명:이석증 : 耳石症 Or 반고리관돌증 : 후반규관의 정(頂)에 결석이 존재하는 것 : cupulolithiasis ) 

◈ 최근 어떤 모임에서 식사를 하고
일어서다가 아내가 엉덩방아를 찧었다,
바닥에 카펫이 깔려 다친데가 없어 다행이었지만
넘어져 골반이부서지는 노인들이 허다하다.
그런 노인들 1/4'은 6개월 이내에
죽게 되는 것이 상례라고 한다.
그러니 노인들에겐 넘어지는 게 무척 위험한 일이다.

◈ 왜! 노인들은 잘 넘어지나?

여태까지는 노인들이 잘 넘어지는 이유는

다리가 약해지거나

정신이 흐려지거나,

시력'이 감퇴되거나,

걸음걸이'가 둔해지기 때문이라고 의사들은 믿어 왔다.

허나,

지난 5월호 - 내과의학 학지'에

 발표된 연구결과를 보면,

◈ 노인들이 잘 넘어지는 이유는

내이전정(內耳前庭 also, 平衡感覺 : sense of equilibrium in the inner ear/the vestibule of the inner ear) 기능장애 때문이라고 한다.
내이전정은 귀 안쪽에 있는 기관으로
균형을 감지하는 기관'이다,
균형감지에 이상이 생기니 잘 넘어질 수밖에 없다,
40세 이상 미국인 35%와 60세 이상 노인들 50%가
내이전정 기능장애자라고 한다.

이 연구는 메릴랜드의 볼티모어에 있는
존스홉킨스 의대 이비인후과< Johns Hopkins School of Medicine (JHUSOM),Otolaryngology> 교수

유리 아그라월<Yuri agrawal : Neurotology : Balance (vestibular) Disorders>'의사'가 주도하였다.

Dr.YuriAgrawal MD practices otolaryngology in Baltimore, Maryland.

Office Address

601 North Caroline Street

Baltimore, MD 21287

Phone : (410) 955-1080

이 연구팀'은 2001년'부터 2004년'까지 실시한

국가 보건 및 영양시험 설문조사'에 참가하였던

5086명'의 성인에서 얻어낸 데이터'를 분석했다.

◈ 내이전정 기능장애자는
어지러움을 느끼기 때문에 잘 넘어지는 게 당연하다"고

아그라월 의사가 설명했다,

어지러움을 느끼는 장애자는 넘어질 찬스가 12'배나 더 높고,

 어지러움을 느끼지 않는
장애자도 넘어질 위험도가 3'배 정도 더 심했다.

내이전정 기능장애자는 귀가 멀어질 위험도도 높았다.
내이전정의 위치가 청각기관에 가깝고,

 혈관을 공유하기 때문이라고 했다.
내이전정은 머리의 회전 운동 방향에 관한 감각정보를 뇌에 보낸다.

◈ 사람은 내이전정에서 오는 신호와 더불어

시각과 촉각을 이용해 균형을 유지한다.
그런데 내이전정에 이상이 생기면

 균형을 유지하기가 어렵게 된다.
아직 내이전정 기능장애의 원인은 확실히 모르지만

노화가 주원인이고, 흡연,고혈압증 당뇨병 탓일 수도 있다고 전문가들이 얘기한다.

Survey suggests higher risk of falls due to dizziness

in middle-aged and older Americans

from : e! Science News

Published: Monday, May 25, 2009 - 15:50 in Health & Medicine

검진은 용이하다.

패드를 깐 표면에 아무 것도 잡지 않고 서서
눈을 감으면 어지러워 넘어지는사람은 내이전정 기능장애자다.

매년 한 번씩 이비인후과 의사에게진단을 받아보는게 안전하다.
미국의 질병관리 및 예방센터의통계에 의하면,

 매년 미국에선 넘어져 죽게 되는 사람이 1만 5000명이 넘고
넘어져 다치는 노인이 300만이 넘는다.

다치는 사람은 곧 남에게의존해 살게 되니
개인의 자유를 잃는다.

◈ 그래서 치료비도 급증한다.

넘어져 다친 환자들 치료비가 연 200억불이 넘는다.
잘 넘어지지 않도록 하자면 균형 운동이 필요하다.
처음엔 뭣이든 한손으로 잡고 단단 한 마루위에서 한발로 서는 연습을 하고

나중엔 아무 것도 잡지 않고 한발로 서는 연습을 한다.

그 다음엔 눈을 감고 연습을 반복한다.
나중엔 물렁한 카펫이나 방석이 깔린 곳에 서서  연습하는 게 좋다.
자리에서 일어설 땐 서서히 일어서고,
뭣이든 한 손으로 잡고 계단을 오르내리고,

◈ 양손에 물건을 들고 걷지 말고
넘어져도 한손으로 땅을 짚으면 골반에 충격을 덜어준다.

A full third of American adults, 69 million men and women over age 40,

 are up to 12 times more likely to have a serious fall

 because they have some form of inner-ear dysfunction that throws them off balance

 and makes them dizzy, according to Johns Hopkins experts.

 Among the other key findings of the three-year survey and study on the subject by the Johns Hopkins team are

 that a third of this group, or more than 22 million, were unaware of their vulnerability,

 having had no previous incidents of disequilibrium or sudden falls to suggest that anything was wrong.

In the survey, to be published in the Archives of Internal Medicine online May 25,

 these asymptomatic people were three times more likely to suffer a potentially fatal fall than people with a healthy sense of balance,

whereas people already experiencing symptoms of imbalance had a 12-fold increase in risk.

Accidental falls are among the leading causes of death in the elderly, killing an estimated 13,000 seniors each year

 in the United States and resulting in more than one and a half million visits to hospital emergency rooms,

experts say.

"Vestibular imbalances need to be taken seriously because falls can be fatal and injuries can be painful,

 lead to long hospital stays and result in significant loss in quality of life," says Lloyd B. Minor, M.D.,

 the Andelot Professor and director of otolaryngology ? head and neck surgery at the Johns Hopkins University School of Medicine.

 Minor says that recent government reports estimate that fatal falls in the elderly cost the U.S.

Medicare program nearly $1 billion in hospital charges,

and those injured with broken bones cost an additional $19 billion.

More than 5,000 men and women over age 40 participated in the survey,

 which took three years to complete and involved specialized exams and balance testing to find out

who had vestibular dysfunction, its early signs and symptoms, and who did not.

And the chance of having a balance problem,

survey results showed, increases with age and diabetes.

 Eighty-five percent of men and women over age 80 had an imbalance problem,

23 times more than people in their 40s. And people with diabetes were 70 percent more likely to suffer from vestibular problems. Researchers say this is likely due to damage done by high blood sugar levels to the hair cells in the inner ear

 that facilitate balance control and to the long-term damage from diabetes to the inner ear's small blood vessels.

"Our survey shows that balance testing needs to be part of basic primary care,

and that all physicians need to be monitoring and screening their patients for vestibular dysfunction

so that we can take preventive measures to guard against falling," says Minor.

Lead study investigator Yuri Agrawal, M.D., says one reason for the large numbers of undiagnosed

and untreated individuals is that balance testing requires specialized training

and the tests take more time and effort to perform than other diagnostic or screening procedures.

As part of the new survey,

study participants were subjected to a half dozen key tests of unsteadiness, including physical exams.

Balance function was assessed by subjects' ability to stand upright with and without visual cues,

 such as being able to stand upright while wearing a blindfold or with their eyes closed,

or by not having to use their arms to maintain balance while standing on a foam-padded mat.

"Now that we have identified the magnitude of balance problems,

primary care physicians are more likely to be on the look out for its early signs and symptoms,

and more attuned to when a patient needs to be referred to a physical therapist," Agrawal says.

Minor points out that physical rehabilitation exercises can aid people with vestibular dysfunction.

 Balancing and walking exercises can be used to train the brain to compensate for inner-ear deficits

and episodes of dizziness. One such exercise has unsteady people practice standing on one leg,

 while resting the other leg on a Styrofoam cup and trying not to crush it.

Another exercise has people turning their head while walking.

Minor adds that people with vestibular dysfunction can take preventive steps to avoid falls in their homes,

 such as installing guard rails along stairs or hallways where a fall might occur,

making sure rooms are well lit, and removing carpeting in places where people are more prone to trip.

Agrawal says the team's next steps are to eval‎!uate screening tools for identifying as early as possible

 which people are at a heightened risk of falling.

She also says other risk factors, such as sleep patterns and nutrient deficiencies,

 which may play a role in predicting risk of falling, need further study.

Various rehabilitation techniques should also be examined to pinpoint which techniques work best at preventing falls and,

ultimately, to allow people to live longer and healthier lives.

Source: Johns Hopkins Medical Institutions

[hiker]

근데 특이한 현상 하나. 90이 넘은 할머니 이리저리 10번도 더 넘어지셨는데 별탈없이 지내심. 특징은 절대 병원 안가심 ㅋㅋㅋ

[황문철]

타고난 건강체질이신가 보네요.^^