Clinical diagnosis of Ménière's disease: how useful are the American Academy of Otolaryngology Head and Neck Surgery Committee on Hearing and Equilibrium guidelines?

2007 ◽  
Vol 122 (8) ◽  
pp. 773-779 ◽  
Author(s):  
E Stapleton ◽  
R Mills
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Neck Surgery ◽  
Meniere’S Disease ◽  
Head And Neck Surgery ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

AbstractIntroduction:Ménière's disease is a diagnosis requiring expert clinical judgment. There are several differences between the American Academy of Otolaryngology Head and Neck Surgery diagnostic guidelines and Prosper Ménière's original description of the disease.Methods:Six hundred and fifty patients attending a specialist balance clinic had their clinical profiles fully analysed according to each set of diagnostic criteria.Results:Application of the American Academy of Otolaryngology Head and Neck Surgery guidelines resulted in the diagnosis of three times more patients than did use of Ménière's diagnostic criteria. Treatment options for patients in both groups were similar. It is unlikely that the application of different diagnostic criteria would have an effect on the treatment of individual patients.Discussion:The American Academy of Otolaryngology Head and Neck Surgery guidelines are more sensitive and less specific in diagnosing Ménière's disease than Prosper Ménière's original description. Standardised criteria should be applied across published series, in order to make results accurate, comparable and useful in the long term. We would recommend the introduction of a stricter diagnostic category for definite Ménière's disease.

scholarly journals Is Vestibular Meniere's Disease Associated With Endolymphatic Hydrops?

2020 ◽  
Vol 7 ◽  
Author(s):  
Yuka Morita ◽  
Kuniyuki Takahashi ◽  
Shinsuke Ohshima ◽  
Chihiro Yagi ◽  
Meiko Kitazawa ◽  
...  
Keyword(s):  
American Academy ◽  
Endolymphatic Hydrops ◽  
Systemic Disease ◽  
Depression Scale ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Background: Vestibular Meniere's disease (American Academy of Ophthalmology and Otolaryngology, 1972) also known as possible Meniere's disease (American Academy of Otolaryngology Head and Neck Surgery, 1995) or vestibular type of atypical Meniere's disease (V-AMD) (Japan Society for Equilibrium Research, 2017) is characterized by an episodic vertigo without hearing loss. Though named as Meniere's disease (MD), this entity may not be caused solely by endolymphatic hydrops (EH).Objective: To estimate the role of EH in vestibular Meniere's disease in comparison with definite Meniere's disease.Methods: Thirty patients with unilateral definite MD and 16 patients with vestibular Meniere's disease were included. Those who met the criteria for definite or probable vestibular migraine were excluded. All patients underwent vestibular assessments including inner ear MRI 4 h after intravenous gadolinium injection, bithermal caloric testing, directional preponderance of vestibulo-ocular reflex in rotatory chair test, cervical- and ocular-vestibular evoked myogenic potential, stepping test, dizziness handicap inventory (DHI), and hospital anxiety and depression scale (HADS). All above tests and frequency/duration of vertigo spells were compared between vestibular Meniere's disease and MD.Results: Even in unilateral MD, cochlear and vestibular endolymphatic hydrops (c-, v-EH) were demonstrated not only in the affected side but also in the healthy side in more than half of patients. Positive rate of v-EH in vestibular Meniere's disease (68.8%) was as high as that of MD (80%). In vestibular Meniere's disease, the number of bilateral EH was higher in the vestibule (56.3%) than that in the cochlea (25.0%). There were no differences in vestibular tests and DHI between vestibular Meniere's disease and MD; however, the frequency of vertigo spells was lower in vestibular Meniere's disease (p = 0.001). The total HADS score in the MD group was significantly higher than that in the vestibular Meniere's disease group.Conclusions: MD is a systemic disease with bilateral involvement of inner ears. V-EH is a major pathophysiology of vestibular Meniere's disease, which would precede c-EH in the development of vestibular Meniere's disease, a milder subtype of MD. MRI is useful for differentiating MD from other vertigo attacks caused by different pathologies in bringing EH into evidence.

Ménière's disease clinical subtypes in a population from the USA

2019 ◽  
Vol 134 (1) ◽  
pp. 24-28 ◽  
Author(s):  
J Crossley ◽  
A S Hussaini ◽  
H J Kim ◽  
M Hoa
Keyword(s):  
Neck Surgery ◽  
Meniere’S Disease ◽  
European Population ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Ménière's Disease

AbstractObjectiveTo ascertain the distribution of Ménière's disease phenotype subgroups in a US-based cohort, based on a recently introduced classification scheme utilising a Spanish and Portuguese cohort.MethodsA retrospective, cross-sectional, single-institutional chart review was conducted. The electronic medical records of Ménière's disease patients were identified using International Classification of Diseases codes at a tertiary referral centre and reviewed to extract subgroup-defining features. Patients with definite Ménière's disease as per American Academy of Otolaryngology–Head and Neck Surgery criteria were categorised into one of five subgroups, for unilateral and bilateral Ménière's disease.ResultsEighty-one patients with definite Ménière's disease were identified. Seventy-two cases of unilateral Ménière's disease were observed: 52.8 per cent were type 1, 20.8 per cent were type 2, 4.2 per cent were type 3, 18.1 per cent were type 4, and 4.2 per cent were type 5. This cohort differed significantly in distribution to a comparison Mediterranean cohort (p < 0.01). Nine cases of bilateral Ménière's disease were observed.ConclusionThe distribution of unilateral Ménière's disease subtypes in this US population was different from that observed in a European population.

Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience

2005 ◽  
Vol 119 (5) ◽  
pp. 391-395 ◽  
Author(s):  
Gunesh P Rajan ◽  
Sobani Din ◽  
Marcus D Atlas
Keyword(s):  
Endolymphatic Hydrops ◽  
Neck Surgery ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Pressure Treatment ◽  
Menière's Disease ◽  
Ménière's Disease

Objectives: Transtympanic pressure has been shown to influence endolymphatic hydrops. As endolymphatic hydrops plays a key role in Ménière’s disease, a few studies, undertaken by the inventors, manufacturers and associates of the Meniett device,have demonstrated positive short-term effects of transtympanic pressure treatment via the Meniett device in medically intractable Ménière’s disease. The aim of our study was to independently investigate the long-term efficacy and safety of transtympanic pressure treatment in the management of recalcitrant vertigo in Ménière’s disease.Design: Cross-sectional case study.Setting: Tertiary referral centre.Participants: Eighteen patients with Ménière’s disease, suffering from medically intractable symptoms. All patients in the study had Ménière’s disease according to the criteria of the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head & Neck Surgery.Main outcome measurements: Outcome and severity of symptoms were assessed, using the six-point functional scale and the vertigo visual analogue scale (VAS), as recommended by the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology, Head & Neck Surgery. Changes of pure tone average thresholds and vestibular calorics before and during treatment with the Meniett device were recorded. The mean follow-up time was 18 months.Results: Twelve out of 18 patients showed significant improvement in the functional score and in the VAS. Five patients displayed an audiometric improvement, out of which three patients showed a pertaining significant hearing gain of more than 10 dB; the remainder had stable hearing levels. Of six patients without any improvement, four had previous invasive surgery for theirMénière’s disease and two had previous vestibular ablation with gentamicin.No changes in vestibular function were noted. There were no complications duringthe treatment with the Meniett device.Conclusion: According to this independent study, the Meniett device seems to be a minimally invasive, non-destructive treatment tool, which can reduce vertigo and associated functional handicap in Ménière’s disease. These effects are maintained up to 18 months after treatment so far. Previous surgical or chemical vestibular ablation procedures may adversely influence the effect of the Meniett device.

Contemporary Role of Endolymphatic Mastoid Shunt Surgery in the Era of Transtympanic Perfusion Strategies

2008 ◽  
Vol 117 (12) ◽  
pp. 871-875 ◽  
Author(s):  
Lisa Lee ◽  
Myles L. Pensak
Keyword(s):  
Endolymphatic Hydrops ◽  
Neck Surgery ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Type I ◽  
Shunt Surgery ◽  
Menière's Disease ◽  
Ménière's Disease

Objectives: Although there exist undisputed methods to permanently silence the aberrant end organ, controversy surrounds the durable efficacy of non-ablative interventions. This study provides a contemporary review of our institution's clinical experience in performing endolymphatic mastoid shunt surgery (EMSS) in patients with medically refractory endolymphatic hydrops, or Meniere's disease. Methods: Between 1984 and 2002, 1,612 patients were referred to our institution with a diagnosis of Meniere's disease. Of these referrals, 1,172 patients met the criteria for Meniere's disease. Although 553 patients responded to medical management, 486 patients underwent EMSS and 133 patients had refractory disease that required chemical or surgical obliterative interventions. The retrospective study utilizes data collected on 226 patients who were followed for a minimum of 5 years. Results: Overall, 78% patients responded favorably to EMSS, according to the functional level scale and class categories delineated by the American Academy of Otolaryngology-Head and Neck Surgery 1995 guidelines for control of vertigo. According to the Arenberg anatomic classification for endolymphatic sac location, EMSS achieved adequate control of vertigo in 86% of type I cases, 90% of type II cases, and 82% of type III cases. Conclusions: Endolymphatic mastoid shunt surgery is a relatively safe, effective procedure for the long-term control of vertigo in patients with medically refractory Meniere's disease.

Intratympanic gentamicin in Ménière's disease: our experience

2011 ◽  
Vol 125 (4) ◽  
pp. 363-369 ◽  
Author(s):  
L Pérez Delgado ◽  
J Fraile Rodrigo ◽  
P Astier Peña
Keyword(s):  
Medical Treatment ◽  
Neck Surgery ◽  
Good Alternative ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Intratympanic Gentamicin ◽  
Ménière's Disease

AbstractAims:To analyse intratympanic gentamicin injection as a treatment option in patients with monolateral Ménière's disease resistant to medical treatment.Material and methods:Longitudinal, prospective, descriptive study of response to gentamicin treatment in 71 patients diagnosed with Ménière's disease and treated medically for more than a year, unsuccessfully. American Academy of Otolaryngology-Head and Neck Surgery criteria were used for diagnosis and follow up.Results:Complete vertigo control was obtained in 65.6 per cent of patients, and complete or substantial control in 84.37 per cent. Thirteen patients (18.3 per cent) suffered significant hearing loss.Conclusion:This intratympanic gentamicin injection protocol enabled effective vertigo control in most patients, and represents a good alternative to more aggressive techniques for the treatment of Ménière's disease which does not respond to medical treatment.

scholarly journals UNILATERAL MENIERE’S DISEASE

2016 ◽  
Vol 23 (01) ◽  
pp. 093-098
Author(s):  
Wajahat Bangash ◽  
Altaf Hussain ◽  
Dr. Muhammad Javed Aslam ◽  
Atif Sharif ◽  
Tallat Najeeb
Keyword(s):  
Good Control ◽  
Neck Surgery ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Intratympanic Gentamicin ◽  
Degree Of Disability ◽  
Ménière's Disease

Meniere’s disease is chronic progressive disease with unclear idiopathic etiologyand symptomatic improvements with treatment. Objectives: To analyze the efficacy of lowdose intratympanic injection of gentamicin for vertigo control in unilateral Meniere’s disease.Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM &IMDC Islamabad. Materials & Methods: Gentamicin was used intra tympanically in thismulticentre study of 75 patients over a period of 8.5 years between 1st January 2005 to 30th June2013 in definite Meniere’s disease according to the 1995 Document of American academy ofotolaryngology- Head and Neck Surgery (AAO-HNS).All these centers followed same criteriaand procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middleear through the grommet under microscope and followed up for 3 months and two years. Thestaging of disease (hearing thresholds) the degree of disability (frequency of attacks per month)and the functional level were assessed before and after treatment. Results: Among 75 patients,41 were female & 34 were males between age ranges of 25 to 70 years. Most of the patients inthe study had stage 2 (23/75) and stage 3 (41/75) Meniere’s disease. About 68(91%) patientswere having good control of vertigo at the end of two year of intratympanic gentamicin withoutany loss of hearing. Conclusion: A single Low dose intratympanic gentamicin is effective incontrolling vertigo in patients with Meniere’s disease with no further deterioration in hearing forat least two years follow up.

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