Meniere's Disease at the National Institute on Deafness and Other Communication Disorders
Ménière's disease is an abnormality of the inner ear causing a host of symptoms, including vertigo or severe dizziness, tinnitus or a roaring sound in the ears, fluctuating hearing loss, and the sensation of pressure or pain in the affected ear. The disorder usually affects only one ear and is a common cause of hearing loss. Named after French physician Prosper Ménière who first described the syndrome in 1861. Read more at the National Institute on Deafness and Other Communication Disorders
Information on Meniere's Disease at the Washington University School of Medicine
Periodic attacks of vertigo ( the so-called Ménière's "attack") is the most disruptive of the symptoms to the patient. It is usually the vertigo attack which causes the patient to seek medical treatment. Typically, vertigo occurs in the form of a series of attacks over a period of weeks or months, interspersed by periods of remission of variable duration. The attack consists of a period of dizziness or vertigo (dizziness may include a feeling of unsteadiness; the term vertigo is normally reserved for the perception of spinning). The sensation of spinning may produce nystagmus (a beating of the eyes from side to side), nausea, vomiting, sweating and all the symptoms normally associated with extreme motion sickness. The onset of vertigo may be preceded by a sensation of fullness or pressure in the ear, increased hearing loss and tinnitus, as described below. The onset is frequently sudden, reaching peak intensity within minutes and lasting for an hour or more before subsiding. Unsteadiness may persist for the following hours or days. Read more at The Department of Otolaryngology, Washington University School of Medicine.
Meniere's disease: Essentials at Consumer Reports
What is it? What are the symptoms? How common is it? What will happen? Key points about treatments at Consumer Reports.
Podcast: Hearing Loss - Meniere’s Disease
Otolaryngologist Dr. Ted Meyer talks about Meniere’s disease and associated symptoms, which include unilateral hearing loss, tinnitus, vertigo, and fullness in the effected ear. He focuses on the fluctuating nature of the disease and discusses potential causal factors. In this otolaryngology podcast, Dr. Meyer goes over treatment methods, including lifestyle changes as well as medical and surgical interventions. Listen at the Medical University of South Carolina Podcast Library.
Video: Vertigo Management in Meniere's Disease
Coping with hearing loss and vestibular function loss can severely alter a person's day to day life. In this program, Dr. Duckert, who works with patients to treat a variety of conditions that affect hearing and balance, reviews Meniere's Disease, its symptoms and treatment. Watch at the University of Washington.
ACR Appropriateness Criteria® vertigo and hearing loss.
The evaluation of vertigo and balance disorders, of which Meniere's disease is one type, can be difficult. Imaging studies, such as MRI, CT scans, and x-rays can assist in an accurate diagnosis. The American College of Radiology has issued guidelines regarding the most appropriate use of these imaging tools. See major recommendations from the National Guideline Clearinghouse.
Abstract: Clinical diagnosis of Ménière's disease: How useful are the American Academy of Otolaryngology Head and Neck Surgery Committee on Hearing and Equilibrium guidelines?
Making the diagnosis of Meniere's disease requires clinical judgment as to whether an individual's symptoms meet the published criteria for Meniere's disease. The original criteria, proposed by Prosper Meniere, were more strict than the American Academy of Otolaryngology Head and Neck Surgery guidelines for the diagnosis of Meniere's disease. Most studies which have enrolled patients with a diagnosis of Meniere's disease do not distinguish between which set of criteria an individual patient meets. Therefore, the conclusions drawn from these studies may, or may not, apply fully to both sets of patients. Read more from PubMed.
Abstract: The effect of the Meniett device in patients with Ménière's disease: long-term results.
The Meniett device, a small hand-held device which is used at home to introduce pulses of low pressure into the ear, has been developed to lessen the frequency and severity of episodic vertigo in Meniere's disease. This study of 12 patients who had used the Meniett device over a period of several years revealed at least some improvement in the majority of them. Read more at PubMed.
Abstract: Exploring the Evidence Base for Acupuncture in the Treatment of Ménière's Syndrome—A Systematic Review
There is little available research on acupuncture for Meniere's disease, and the vast majority of such research was conducted in China. Two thirds of these studies were published only in Chinese languages. Twenty seven published studies in both English and Chinese were reviewed; overall there appeared to be a positive benefit to the use of acupuncture in both the acute phase of Meniere's disease and for longer term use. This research holds out hope that acupuncture may eventually be a tool in managing the symptoms of Meniere's disease, but points out the difficulties in assuming that the results obtained in Chinese studies can be translated to the American population. Full text available at PubMed.
Abstract: High-dose intratympanic gentamicin instillations for treatment of Meniere's disease: long-term results
This study aimed to assess the long term success rate of high-dose intra-tympanic gentamicin (using injections of a toxic antibiotic into the ear drum) to destroy the parts of the inner ear related to Meniere's symptoms. A group of 14 patients who had failed medical or surgical therapies for Meniere's disease were followed for an average of 10 years after intra-tympanic gentamicin treatment. The majority (85 percent) reported sustained improvements in vertigo symptoms. 42 percent had some hearing loss as a presumed result of the treatments. More at PubMed.
Abstract: Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study
This French retrospective study compared patients who had undergone surgical vestibular neurectomy (cutting the vestibular nerve which regulates balance) to patients who had undergone non-surgical chemical labyrinthectomy (injections of a destructive substance into the inner ear). The outcome for each group was similar, with both groups having improvements in the frequency and severity of vertigo episodes. Read more at PubMed.
Abstract: Time course of repeated intratympanic gentamicin for Ménière's disease
When intratympanic gentamicin is used for control of vertigo in Meniere's disease, how many administrations are needed? Johns Hopkins' researchers attempted to answer this question. They administered this treatment at 6 week intervals on patients with Meniere's disease, and found that more than half of patients responded to only one injection. 96 percent had responded after 4 treatments. More at PubMed.
Abstract: Screening for vestibular disorders: a study of clinicians' compliance with recommended practices
Dizziness is a common complaint in medical practice, and has many causes, some of which may be vestibular disorders such as Meniere's disease. This study looked at the charts of 157 patients who had received a diagnosis of dizziness by their physician. Most physicians asked for the patient's description of the dizziness, and used this information to assume the cause of the dizziness. Others did not ask for a patients description of dizziness to decide upon its causation. Only a small percentage of physicians did a simple postural test to evaluate for a common type of vertigo. The study's authors conclude that many patients who may have vertigo due to vestibular dysfunction are being not being identified by their physicians. More at PubMed.
Abstract: Contemporary role of endolymphatic mastoid shunt surgery in the era of transtympanic perfusion strategies
For patients who do not respond to medical therapy, there are effective ablative methods (using intratympanic gentamicin injections) for destroying the swollen inner ear endolymphatic sacs that cause Meniere's disease. This procedure will cause decreased hearing in some patients, and therefore some will elect a non-destructive surgical procedure called endolymphatic mastoid shunting. There has not been a consensus among otolaryngologists as to the effectiveness of this procedure. This University of Cincinnati study followed 226 patients over a 5 year period after this procedure, and found that 78 percent had good results. More at PubMed.
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