Did you mean: meniere s disease
-
Current Opinion in Neurology Feb 2022This article reviews recent developments in Ménière's disease including etiologic, diagnostic, and therapeutic investigations that have changed the landscape for... (Review)
Review
PURPOSE OF REVIEW
This article reviews recent developments in Ménière's disease including etiologic, diagnostic, and therapeutic investigations that have changed the landscape for medical providers. These updates shed light onto the complex nature of Ménière's disease and generate additional means to provide optimal care to patients.
RECENT FINDINGS
Given the multifactorial cause of Ménière's disease, five subtypes of Ménière's disease have recently been proposed. A knowledge of these subtypes will aid in the development of an appropriate treatment algorithm. Although newer treatments have not been developed, stepwise treatment algorithms have been proposed and can improve patient care. New MRI modalities and serum testing hold promise as clinical clues and biomarkers.
SUMMARY
As these updated diagnostic criteria are used, Ménière's disease can be identified and treated more precisely. This will in turn allow for future randomized controlled studies to improve the quality of treatment options available. Future imaging, vestibular testing, and the potential for serum biomarkers may illuminate additional diagnostic criteria, only furthering the improvement in clinical care.
Topics: Algorithms; Humans; Magnetic Resonance Imaging; Meniere Disease
PubMed: 34864755
DOI: 10.1097/WCO.0000000000001021 -
BMJ Clinical Evidence Nov 2015Menière's disease causes feelings of fullness or pressure in the ear, hearing loss, tinnitus, and recurrent bouts of vertigo, and mainly affects people aged 30-60... (Review)
Review
INTRODUCTION
Menière's disease causes feelings of fullness or pressure in the ear, hearing loss, tinnitus, and recurrent bouts of vertigo, and mainly affects people aged 30-60 years. Menière's disease is at first progressive but fluctuating, and episodes can occur in clusters. Vertigo usually resolves eventually, but the hearing deteriorates and the tinnitus and pressure may persist regardless of treatment.
METHODS AND OUTCOMES
We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of combination treatment (betahistine plus thiazide diuretic) to prevent attacks and delay disease progression of Menière's disease? What are the effects of intratympanic interventions to prevent attacks and delay disease progression of Menière's disease? What are the effects of non-drug interventions to prevent attacks and delay disease progression of Menière's disease? What are the effects of dietary interventions to prevent attacks and delay disease progression of Menière's disease? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).
RESULTS
At this update, searching of electronic databases retrieved 200 studies. After deduplication and removal of conference abstracts, 151 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 100 studies and the further review of 51 full publications. Of the 51 full articles evaluated, five systematic reviews and four RCTs were added at this update. We performed a GRADE evaluation for eight PICO combinations.
CONCLUSIONS
In this systematic overview, we categorised the efficacy for seven interventions based on information about the effectiveness and safety of betahistine plus thiazide diuretic, caffeine restriction, intratympanic corticosteroids, intratympanic gentamicin, psychological support, salt restriction, and vestibular rehabilitation.
Topics: Diet; Humans; Meniere Disease
PubMed: 26545070
DOI: No ID Found -
Medwave Oct 2017Menieres disease is an inner ear disorder characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Betahistine has been used to reduce... (Meta-Analysis)
Meta-Analysis Review
PROBLEM
Menieres disease is an inner ear disorder characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Betahistine has been used to reduce intensity and frecuency of vertigo attacks, but there is controversy regarding its effectiveness.
METHODS
To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
RESULTS AND CONCLUSIONS
We identified four systematic reviews including 12 trials overall. We concluded betahistine might reduce the number of attacks, vertigo intensity and lead to a symptomatic improvement according to global judgement in patients with Menieres disease, but the certainty of evidence is low. On the other hand, it probably does not have significant adverse effects.
Topics: Betahistine; Humans; Meniere Disease; Treatment Outcome; Vasodilator Agents; Vertigo
PubMed: 29099816
DOI: 10.5867/medwave.2017.08.7068 -
Advances in Oto-rhino-laryngology 2019This article reviews 3 aspects of Meniere's disease (MD), which have been recently revisited: namely, the pathologic mechanism causing the attacks of vertigo, the... (Review)
Review
This article reviews 3 aspects of Meniere's disease (MD), which have been recently revisited: namely, the pathologic mechanism causing the attacks of vertigo, the clinical diagnosis, and the medical and surgical treatments. The characteristic attacks of vertigo are unlikely to be due to membrane ruptures, so a hypothesis that the vertigo is caused by a volume of endolymph shifting suddenly from the cochlea into the pars superior is suggested. The definite diagnosis according to the American Academy of Otolaryngology HNS 1995 criteria [
13 ] failed to exclude vestibular migraine sufficiently and a revision in 2015 [14 ] has partly addressed this problem but another method which stresses the interaction of the cochlear and vestibular symptoms is described. The treatment of MD has been updated, providing evidence for each popular therapy. Newer treatments using intratympanic medications including steroid solutions and gentamicin are discussed. Finally, the role of cochlear implants is mentioned.Topics: Anti-Bacterial Agents; Diagnosis, Differential; Gentamicins; Humans; Meniere Disease; Otologic Surgical Procedures; Practice Guidelines as Topic; Steroids; Vestibular Function Tests
PubMed: 30947172
DOI: 10.1159/000490274 -
Journal of Neurology Apr 2016Menière's disease is a chronic condition with a prevalence of 200-500 per 100,000 and characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus,... (Review)
Review
Menière's disease is a chronic condition with a prevalence of 200-500 per 100,000 and characterized by episodic attacks of vertigo, fluctuating hearing loss, tinnitus, aural pressure and a progressive loss of audiovestibular functions. Over 150 years ago, Prosper Menière was the first to recognize the inner ear as the site of lesion for this clinical syndrome. Over 75 years ago, endolymphatic hydrops was discovered as the pathologic correlate of Menière's disease. However, this pathologic finding could be ascertained only in post-mortem histologic studies. Due to this diagnostic dilemma and the variable manifestation of the various audiovestibular symptoms, diagnostic classification systems based on clinical findings have been repeatedly modified and have not been uniformly used in scientific publications on Menière's disease. Furthermore, the higher level measures of impact on quality of life such as vitality and social participation have been neglected hitherto. Recent developments of high-resolution MR imaging of the inner ear have now enabled us to visualize in vivo endolymphatic hydrops in patients with suspected Menière's disease. In this review, we summarize the existing knowledge from temporal bone histologic studies and from the emerging evidence on imaging-based evaluation of patients with suspected Menière's disease. These indicate that endolymphatic hydrops is responsible not only for the full-blown clinical triad of simultaneous attacks of auditory and vestibular dysfunction, but also for other clinical presentations such as "vestibular" and "cochlear Menière's disease". As a consequence, we propose a new terminology which is based on symptomatic and imaging characteristics of these clinical entities to clarify and simplify their diagnostic classification.
Topics: Animals; Endolymphatic Hydrops; Humans; Magnetic Resonance Imaging; Meniere Disease; Quality of Life
PubMed: 27083887
DOI: 10.1007/s00415-015-7930-1 -
Medwave Mar 2017Ménières disease affects the inner ear and its main symptoms are vertigo, hearing loss and fluctuating aural symptoms. Nowadays, there are many therapeutic... (Meta-Analysis)
Meta-Analysis Review
Ménières disease affects the inner ear and its main symptoms are vertigo, hearing loss and fluctuating aural symptoms. Nowadays, there are many therapeutic alternatives, being the use of intratympanic corticosteroids one that has become popular. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple databases. We identified four systematic reviews including 15 studies overall, of which seven were randomized trials. We extracted data and generated a summary of findings table using the GRADE approach. We concluded intratympanic corticosteroids probably do not decrease tinnitus, and might not decrease vertigo, hearing loss or aural fullness sensation in Ménières disease. Intratympanic corticosteroids probably do not cause important adverse effects.
Topics: Glucocorticoids; Hearing Loss; Humans; Injection, Intratympanic; Meniere Disease; Randomized Controlled Trials as Topic; Tinnitus; Treatment Outcome; Vertigo
PubMed: 28306710
DOI: 10.5867/medwave.2017.6863 -
Medwave Apr 2019Ménière's disease is a disorder of the inner ear characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Positive pressure therapy has... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Ménière's disease is a disorder of the inner ear characterized by episodes of spontaneous vertigo, fluctuating hearing loss and tinnitus. Positive pressure therapy has been used to reduce the intensity and frequency of episodes, but it is not clear whether it is actually effective.
METHODS
We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach.
RESULTS AND CONCLUSIONS
We identified five systematic reviews including 22 studies overall, of which five were randomized trials. We concluded positive pressure therapy probably leads to slightly worse hearing and makes little or no difference in the intensity of vertigo. In addition, we are uncertain whether positive pressure therapy improves functionality or decreases vertigo attacks as the certainty of the evidence has been assessed as very low.
Topics: Databases, Factual; Hearing Loss; Humans; Meniere Disease; Randomized Controlled Trials as Topic; Systematic Reviews as Topic; Tinnitus; Treatment Outcome; Vertigo
PubMed: 30985738
DOI: 10.5867/medwave.2019.03.7609 -
Bratislavske Lekarske Listy 2016The aim of this study is to prove the involvement of the immune response in the etiopathogenesis of some cochleovestibular disorders by a demonstration of antibodies...
OBJECTIVE
The aim of this study is to prove the involvement of the immune response in the etiopathogenesis of some cochleovestibular disorders by a demonstration of antibodies against inner ear antigens and identify the benefits of immunosuppressive therapy.
BACKGROUND
McCabe in 1979 postulated the hypothesis of autoimmune inner ear disease.
METHODS
Sodium dodecyl sulfate polyacrylamid gel electrophoresis and immunoblotting were used to examine the serum of 74 subjects for the presence of antibodies against inner ear antigens. The subjects were divided into three groups: A--subjects with idiopathic progressive sensorineural hearing loss, B--subjects with Menière´s disease, C--healthy subjects. Individuals with proven antibodies received immunosuppressive therapy.
RESULTS
We detected antibodies against inner ear antigens with molecular weight of 30, 50, 60, 80, 100 kDa. In group A they were found in 52% of 25 subjects, in group B in 44% of 25 subjects and they were not detected in group C. An improvement of hearing was recorded in 69% of subjects in group A. An improvement of hearing was observed in 72%, significant relief of vertigo in 81% of subjects in group B.
CONCLUSION
The present study supports the hypothesis of immune-mediated cochleovestibular disease (Tab. 3, Ref. 15).
Topics: Adult; Antibodies; Audiometry, Pure-Tone; Autoantigens; Autoimmunity; Drug Monitoring; Ear, Inner; Female; Hearing Loss, Sensorineural; Humans; Immunologic Tests; Immunosuppressive Agents; Male; Meniere Disease; Middle Aged; Treatment Outcome
PubMed: 26830038
DOI: 10.4149/bll_2016_017 -
Current Opinion in Otolaryngology &... Oct 2023Ménière's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal... (Review)
Review
PURPOSE OF REVIEW
Ménière's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal management continue to be the subject of ongoing debate. Although it is classically believed to be a primary disorder of the inner ear, some clinicians have hypothesized that it is a form of vestibular migraine.
RECENT FINDINGS
Evidence supporting vestibular migraine in the differential of Ménière's disease includes overlap of symptoms, high prevalence of migraines in patients with Ménière's disease, and the efficacy of migraine treatments for symptoms of Ménière's disease in some patients. However, there is far more evidence to support Ménière's disease as a disorder of the inner ear, including genetic and histologic changes of hydrops, imaging studies showing hydropic changes, predominance of low-frequency hearing loss, clinical efficacy of treatments targeted at inflammatory change/hydrops, and clinical efficacy of ablating the vestibular end-organ.
SUMMARY
Although there is conflicting evidence regarding the cause and treatment of Ménière's disease, current evidence favors it as a disorder of the inner ear. Further research is needed to fully understand the mechanisms of Ménière's disease and how to improve diagnosis and treatment outcomes.
Topics: Humans; Meniere Disease; Vestibule, Labyrinth; Deafness; Migraine Disorders; Edema
PubMed: 37610986
DOI: 10.1097/MOO.0000000000000921 -
Handbook of Clinical Neurology 2016Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss,... (Review)
Review
Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss, tinnitus, and aural pressure. Epidemiologic and genomic evidence supports a genetic susceptibility with multiple biochemical pathways involved, including the endocrine system, innate immune response, and autonomic nervous system. Allergens, infectious agents, vascular events, or genetic factors could modify inner-ear homeostasis and trigger MD. The diagnosis of MD is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing loss, tinnitus, and/or fullness) in the affected ear. Headache is also found during the attacks and bilateral involvement is found in 25-40% of cases. Audiologic and vestibular assessment is recommended to monitor the clinical course. The treatment of MD is symptomatic to obtain relief of vestibular episodes and preventive to limit hearing loss progression. Treatment options include sodium restriction, betahistine, intratympanic gentamicin, or steroids and eventually surgery, such as cochlear implantation.
Topics: Audiometry; Autonomic Nervous System; Humans; Meniere Disease
PubMed: 27638077
DOI: 10.1016/B978-0-444-63437-5.00019-4