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The International Tinnitus Journal Jun 2022Meniere's Disease (MD) is an inner ear disorder characterized by spontaneous recurrent vertigo, fluctuating sensorineural hearing loss, aural fullness and low-pitch... (Review)
Review
Meniere's Disease (MD) is an inner ear disorder characterized by spontaneous recurrent vertigo, fluctuating sensorineural hearing loss, aural fullness and low-pitch tinnitus. Therapeutic management of MD includes dietary restriction and medical therapy. A minority of cases is characterized by frequent vertigo attacks, progressive hearing loss and persistent tinnitus even through the continuous medical treatments; this condition is called intractable MD and requires a therapeutic escalation from non-invasive medical treatment to surgical intervention. Invasive procedures include endolymphatic sac surgery, vestibular nerve section and labyrinthectomy. These procedures have a very high success rate on symptom control but may have a severe impact on the hearing function. However, the simultaneous combined approach of demolitive surgery and cochlear implantation may be a valid approach to treat symptoms of intractable MD and preserve hearing function. In the present study, we review current literature focusing on intractable MD to describe and discuss advantages and disadvantages of established and newly proposed surgical treatments for intractable MD.
Topics: Cochlear Implantation; Hearing Loss, Sensorineural; Humans; Meniere Disease; Tinnitus; Vertigo
PubMed: 35861458
DOI: 10.5935/0946-5448.20220007 -
International Journal of Pediatric... Feb 2018This study adopted an inner ear test battery comprising audiometry, and ocular vestibular evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests to...
OBJECTIVE
This study adopted an inner ear test battery comprising audiometry, and ocular vestibular evoked myogenic potential (oVEMP), cervical VEMP (cVEMP), and caloric tests to investigate the sequence of inner ear deficits in pediatric Meniere's disease (MD).
METHODS
From 2005 to 2016, a total of 24 MD children aged <15 years old underwent otoscopy, CT scan, blood test, and an inner ear test battery. Nine subjects were males and 15 were females, with mean age of 12 years. Right ear was affected in 3 patients, left ear in 5 patients, and both ears in 16 patients (67%). Eight (33%) of the 24 MD children had positive family history.
RESULTS
Inner ear deficits in MD children ran from abnormal hearing (25%) to abnormal cVEMP (20%), oVEMP (13%), and caloric (12%) tests, exhibiting a significantly declining sequence from the cochlea, to the saccule, utricle and semicircular canals. Analysis between the laterality and family history revealed a significantly positive correlation.
CONCLUSION
Pediatric MD is rare, accounting for 2.3% prevalence in MD patients. The inner ear deficits in pediatric MD showed a significantly declining sequence from the cochlea, to the saccule, utricle and semicircular canals, mimicking the sequence in adult MD. One-third MD children had positive family history, which may explain the high rate of bilateral affliction and symmetrical hearing levels on both ears.
Topics: Adolescent; Audiometry; Caloric Tests; Child; Ear, Inner; Female; Humans; Male; Meniere Disease; Otoscopy; Vestibular Evoked Myogenic Potentials
PubMed: 29447806
DOI: 10.1016/j.ijporl.2017.11.029 -
The Annals of Otology, Rhinology, and... Sep 2022To quantify the presence of conflicts of interest (COI) in SRs and MAs of Ménières disease treatment and identify any related secondary characteristics of these articles.
OBJECTIVES
To quantify the presence of conflicts of interest (COI) in SRs and MAs of Ménières disease treatment and identify any related secondary characteristics of these articles.
METHODS
A search was conducted on May 28, 2020 to search MEDLINE and Embase databases for SRs or MAs pertaining to Ménières disease published between September 1, 2016 and June 2, 2020. A risk of bias assessment was performed using the Cochrane Collaboration risk of bias assessment criteria.
RESULTS
A total of 13 systematic reviews conducted by 49 authors met the inclusion criteria. Of the 49 authors, 7 (14.3%) were found to have some form of COI. Of these 7 authors, 1 (14.3%) completely disclosed all COI within the SR, 1 (14.3%) disclosed one or more COI but were found to have an additional undisclosed COI, and 5 (71.4%) were found to have only undisclosed COI. One of 2 industry funded SRs (50%) had a high risk of bias, and 1 (50%) of the non-industry sponsored SRs were found to have a high risk of bias.
CONCLUSIONS
Overall authors of SRs pertaining to Ménières disease appear to be properly disclosing COI at higher rates than other fields of medicine; however, further room for improvement has been noted.
Topics: Bias; Humans; Meniere Disease; Systematic Reviews as Topic
PubMed: 34636251
DOI: 10.1177/00034894211051822 -
Laryngo- Rhino- Otologie Aug 2015Menière`s disease is one of the most common inner ear and vestibular disorders. It is defined as the idiopathic syndrome of endolymphatic hydrops (ELH). Despite the... (Review)
Review
Menière`s disease is one of the most common inner ear and vestibular disorders. It is defined as the idiopathic syndrome of endolymphatic hydrops (ELH). Despite the development of several different animal models of ELH, its etiology and pathogenesis is still unresolved. In humans, endolymphatic hydrops may occur spontaneously or as a consequence of specific disorders with distinct inner ear pathologies, e. g., infectious labyrinthitis, noise induced hearing loss or vestibular schwannoma. Recent imaging studies using MRI have shown that hydropic ear disease is associated not only with the full triad of vertigo, hearing, loss and tinnitus/aural pressure, but also with inner ear symptoms that do not fulfill the clinical criteria of definite Menière's disease as set forth by the AAO-HNS. Therefore, terms like "atypical" or "cochlear"/"vestibular" Menière's disease or "forme fruste" should be avoided and the term "Menière's disease" should universally be applied according only to these guidelines. Besides that, the recent possibility of visualizing endolymphatic hydrops on MRI and thereby ascertaining the diagnosis in difficult cases and new audiovestibular function tests for the indirect detection of endolymphatic hydrops show promising results. Evidenced based reviews of currently available therapeutic options still reveal many uncertainties with regard to efficacy, with the exception of the ablative therapies, e. g., intratympanic gentamicin application.
Topics: Animals; Audiometry, Pure-Tone; Diagnosis, Differential; Disease Models, Animal; Endolymphatic Hydrops; Guideline Adherence; Humans; Magnetic Resonance Imaging; Meniere Disease; Prognosis; Vestibular Function Tests
PubMed: 26243634
DOI: 10.1055/s-0035-1555808 -
Current Neurology and Neuroscience... 2015Vertigo and migraine are commonly co-occurring problems. The diagnostic criteria for vestibular migraine have recently been updated in the International Classification... (Review)
Review
Vertigo and migraine are commonly co-occurring problems. The diagnostic criteria for vestibular migraine have recently been updated in the International Classification of Headache Disorders, 3rd edition (beta version), which allow better detection of this under-recognized condition. In many cases, a diagnosis of vestibular migraine will be established based on a typical history of concurrent migraine headache, photophobia, and/or migraine aura with the vertigo. Certain mimickers, such as Ménière's disease, likely exist on a pathophysiologic continuum with vestibular migraine. In our review, we provide an update on the salient literature regarding the diagnosis and management of this condition.
Topics: Diagnosis, Differential; Dizziness; Humans; Meniere Disease; Migraine Disorders; Vertigo
PubMed: 25467406
DOI: 10.1007/s11910-014-0515-z -
Clinical Immunology (Orlando, Fla.) Jul 2023Meniere Disease (MD) is an inner ear syndrome, characterized by episodes of vertigo, tinnitus and fluctuating sensorineural hearing loss. The pathological mechanism...
BACKGROUND
Meniere Disease (MD) is an inner ear syndrome, characterized by episodes of vertigo, tinnitus and fluctuating sensorineural hearing loss. The pathological mechanism leading to sporadic MD is still poorly understood, however an allergic inflammatory response seems to be involved in some patients with MD.
OBJECTIVE
Decipher an immune signature associated with the syndrome.
METHODS
We performed mass cytometry immune profiling on peripheral blood from MD patients and controls. We analyzed differences in state and differences in abundance of the different cellular subsets. IgE levels were quantified through ELISA on supernatant of cultured whole blood.
RESULTS
We have identified two clusters of individuals according to the single cell cytokine profile. These clusters presented differences in IgE levels, immune cell population abundance, including a reduction of CD56 NK-cells, and changes in cytokine expression with a different response to bacterial and fungal antigens.
CONCLUSION
Our results support a systemic inflammatory response in some MD patients that show a type 2 response with allergic phenotype, which could benefit from personalized IL-4 blockers.
Topics: Humans; Meniere Disease; Vertigo; Cytokines; Hearing Loss, Sensorineural; Syndrome; Immunoglobulin E
PubMed: 37178857
DOI: 10.1016/j.clim.2023.109632 -
Expert Review of Neurotherapeutics Feb 2022Meniere's disease (MD) is a chronic disorder of inner ear, characterized by audial and vestibular symptoms. It presents a great variability among patients in terms of... (Review)
Review
INTRODUCTION
Meniere's disease (MD) is a chronic disorder of inner ear, characterized by audial and vestibular symptoms. It presents a great variability among patients in terms of clinical features, etiology, pathology, and response to the same therapy. It's challenging to diagnose and manage for its heterogeneity. Indeed, the consensus is reached that MD has subtypes. Identifying subtypes of MD is important for individualized therapy and further research.
AREAS COVERED
In this review, we examined the heterogeneity of MD. We also included the valid subtyping solutions and updated data regarding the association among subtypes, disease progression, and management.
EXPERT OPINION
MD is an etiologically multifactorial condition, and it might be a constellation of symptoms associated with endolymph hydrops, not a disease entity. So far, MD can be classified as distinct phenotypes and endotype, respectively based on symptoms, pathology, possible etiology, and co-existing condition. Patients in different subtypes present different clinical features and are suitable for different treatment. The identification of these subtypes will benefit both basic and clinical studies of MD, by helping achieve personalized therapy, accurate prognosis prediction and even disease screening in near future. Therefore, MD subtyping is the emerging direction of diagnosis and treatment in the future.
Topics: Ear, Inner; Endolymphatic Hydrops; Humans; Magnetic Resonance Imaging; Meniere Disease
PubMed: 35057670
DOI: 10.1080/14737175.2022.2030221 -
JAMA Otolaryngology-- Head & Neck... May 2022A connection between Meniere disease (MD) and migraine has been proposed, but the temporal association remains unknown.
IMPORTANCE
A connection between Meniere disease (MD) and migraine has been proposed, but the temporal association remains unknown.
OBJECTIVE
To examine the bidirectional association of MD with migraine.
DESIGN, SETTING, AND PARTICIPANTS
This case-control study included participants 40 years or older from the Korean National Health Insurance Service Health Screening Cohort from 2002 to 2015.
MAIN OUTCOMES AND MEASURES
A total of 6919 patients with MD were matched with 27 676 control participants without MD for age, sex, income, region of residence, and index date. The incidence of migraine was analyzed in the MD and matched groups using a stratified Cox proportional hazard regression model. In addition, 35 889 patients with migraine were matched with 71 778 control participants without migraine. The incidence of MD was analyzed using a stratified Cox proportional hazard regression model.
RESULTS
Of 142 262 total participants, 94 611 (66.5%) were women. Migraine occurred in 695 of 6919 patients with MD (10.0%) and 970 of 27 676 matched control participants (3.5%). The MD group demonstrated a 2.22-fold higher risk of migraine than the matched control group (95% CI, 1.99-2.49). Meniere disease was present in 1098 of 35 889 patients with migraine (3.1%) and 781 of 71 778 matched control participants (1.1%). The migraine group had a 1.95-fold higher risk of MD than the matched control group (95% CI, 1.77-2.15).
CONCLUSIONS AND RELEVANCE
The results of this case-control study suggest that patients with MD had a greater risk of migraine occurrence. Furthermore, patients with migraine had a higher risk of MD. Based on the bidirectional association, therapeutics for migraine could potentially be applied to MD and vice versa.
Topics: Case-Control Studies; Cohort Studies; Female; Humans; Incidence; Male; Meniere Disease; Migraine Disorders; Risk Factors
PubMed: 35389472
DOI: 10.1001/jamaoto.2022.0331 -
Annals of the New York Academy of... Apr 2015Meniere's disease is a poorly understood, disabling syndrome causing spells of vertigo, hearing fluctuation, tinnitus, and aural fullness. In this paper, we present a... (Review)
Review
Meniere's disease is a poorly understood, disabling syndrome causing spells of vertigo, hearing fluctuation, tinnitus, and aural fullness. In this paper, we present a review of the histopathology, cytochemistry, and imaging of Meniere's disease. Histopathology is significant for neuroepithelial damage with hair cell loss, basement membrane thickening, and perivascular microvascular damage. Cytochemical alterations are significant for altered AQP4 and AQP6 expression in the supporting cell, and altered cochlin and mitochondrial protein expression. Current developments include imaging techniques to determine the degree and presence of endolymphatic hydrops, and future studies will endeavor to correlate the observance of hydrops with clinical findings.
Topics: Animals; Aquaporins; Humans; Meniere Disease; Vestibule, Labyrinth
PubMed: 25766597
DOI: 10.1111/nyas.12699 -
Otolaryngology--head and Neck Surgery :... Nov 2023To analyze evidence supporting an association between immune-related diseases and Ménière's disease (MD) since it has long been thought to be related to autoimmune... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To analyze evidence supporting an association between immune-related diseases and Ménière's disease (MD) since it has long been thought to be related to autoimmune disorders and allergies.
DATA SOURCES
We retrieved records from Pubmed, Web of Science, Scopus, and Cochrane Library to identify studies published between January 2002 and October 2022.
REVIEW METHODS
Articles were independently assessed by 2 reviewers and verified by a third reviewer. Published cross-sectional studies, cohort/longitudinal studies, case series, and noncomparative cohort studies were considered eligible for inclusion. We conducted a systematic review and meta-analysis according to a registered protocol on the International Prospective Register of Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Selected studies were classified into 2 groups: epidemiological and genetic association studies. Relative frequencies and odds ratios (ORs) for each autoinflammatory/autoimmune disease or genetic marker reported to be associated with MD.
RESULTS
Fifteen studies from 6 countries met our inclusion criteria. Nine are epidemiological studies and 6 are genetic association studies. The epidemiological studies were used to perform 3 different meta-analyses. Airway allergic disease and autoimmune thyroid disease showed a significant association with MD (OR = 2.27 [2.08-2.48] and OR = 1.35 [1.25-1.46]); while rheumatoid arthritis did not (OR = 0.63 [0.28-1.41]). Other comorbidities also showed a significant association with MD like chronic obstructive pulmonary disease, vitiligo, fibromyalgia, arthritis, and psoriasis.
CONCLUSION
Epidemiological evidence supports an association between MD and immune-related disorders in European and Asian populations, with population-specific effects. The evaluation of thyroid diseases, airway allergic diseases, and other inflammatory diseases should be implemented in the clinical management of MD patients.
Topics: Humans; Meniere Disease; Cross-Sectional Studies; Autoimmune Diseases; Cohort Studies; Comorbidity; Hypersensitivity
PubMed: 37272729
DOI: 10.1002/ohn.386