[Direct application of ultrasounds to the vestibular apparatus as a cure for Meniere's disease].
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Humans↗
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Results for “MENIERE'S DISEASE”
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[LATE RESULTS OF ULTRASONIC THERAPY IN MENIERE'S DISEASE].
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Audiometry↗
[ON THE MECHANISM OF THE APPEARANCE OF THE ATTACKS OF VERTIGO IN MENIERE'S DISEASE].
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Humans↗
Vestibular nerve in Meniere's disease.
Biopsy specimens of vestibular nerves of 40 patients with severe Meniere's disease were studied by microscopy. In 17 patients, a translabyrinthine eighth nerve transection was done; in 23 patients, a middle fossa vestibular neurectomy was done. Many of the nerve fibers had thickened and deformed myelin coats; some were thinly myelinated fibers and some showed degraded myelin. No macrophages were present. Occasional vestibular ganglion cells had thin myelin coats. In six patients, there were lighter areas between the fibers. In these there were roughly parallel astrocyte processes, with numerous cytoplasmic filaments. The light areas were surrounded by a basement membrane. Four of these patients showed continuation of vertiginous symptoms after operation and were not helped by surgery. These patients may suffer from a neuropathy that is different from the more common causes of Meniere's disease.
Adult↗
Eustachian tube dysfunction and Meniere's disease: a report of 341 cases.
Tympanometric results were reviewed for 341 cases of Meniere's disease and 200 cases of sensorineural hearing loss of unknown causes. The results indicate that the incidence of Eustachian tube dysfunction in patients with Meniere's disease is nearly the same as in a control group of patients with sensorineural hearing loss of unknown causes: The percentage of patients with Meniere's disease having Eustachian tube dysfunction was similar to the percentage of normal-hearing listeners with Eustachian tube dysfunction reported by Jerger.
Acoustic Impedance Tests↗
Meniere's disease study: three-year progress report.
The results of a three-year study of 120 patients with Meniere's disease has revealed multiple but specific etiology for 48 percent of the patients: (1) Allergy-14 percent (2) Congenital or acquired syphilis-7 percent (3) Adrenal pituitary insufficiency-6 percent (4) Hypothyroidism-3 percent (5) Stenosis of the internal auditory canal-3 percent (6) Trauma, acoustic or physical-3 percent (7) Combination of the above-12 percent. Emotional or psychiatric factors are not involved in the etiology of this disease. The vestibular and cochlear aqueduct on both temporal bones of patients with Meniere's disease could not be visualized in a significantly greater number than a normal control group suggesting an anatomic predisposition to the development of Meniere's disease. Preliminary immunologic viral investigation suggests the possibility of viral etiology in the remaining group considered idiopathic. It is hoped that this study will encourage other investigators to criticize and help intensify our efforts to solve the questions remaining about Meniere's disease.
Adrenal Insufficiency↗
Perilymphatic fistula and Meniere's disease. Clinical series and literature review.
There continues to be considerable confusion concerning the diagnosis and treatment of perilymphatic fistulas (PLFs) and Meniere's disease. This paper reports an 8-year experience with patients whose symptoms were compatible with Meniere's disease but who had some other element that raised the possibility of their having a PLF. This review is a retrospective report on 64 patients who had fluctuating hearing loss, vertigo, tinnitus, and aural fullness typical of Meniere's disease. However, they also had a positive fistula test and/or symptoms beginning immediately after head trauma. They all underwent at least a unilateral PLF repair, and some also underwent an endolymphatic sac-mastoid shunt operation. This report provides a literature review to help put this series' results into perspective. Of those 40 patients who underwent an initial PLF repair, 58% had a successful outcome. Of the 10 patients who underwent an initial PLF repair plus an endolymphatic sac-mastoid shunt, 70% had a successful outcome. Since it is often difficult to distinguish patients with PLFs and secondary endolymphatic hydrops (Meniere's syndrome) from patients with Meniere's disease (idiopathic endolymphatic hydrops), PLF repair is a reasonable first operation, reserving an endolymphatic sac-mastoid shunt operation as a secondary procedure if needed. The decision to consider a PLF repair is guided by a positive fistula test or an immediate onset of Meniere's disease symptom complex after head or ear trauma.
Adolescent↗
Meniere's disease: a long-term follow-up study of hearing loss.
Twenty patients suffering from Meniere's disease or Lermoyez syndrome were studied with respect to the time course of their hearing loss. Careful history-taking as well as repeated audiometry over long time spans (5-20 years) resulted in a longitudinal study of hearing loss at the standard audiometric frequencies. From these time series, correlation coefficients were computed between the changes in both ears at identical frequencies, and for changes in the same ear at different frequencies. Correlations between changes in hearing loss in both ears were more obvious in bilateral Meniere's disease than in unilateral disease. Correlations between changes in hearing loss at different frequencies were also more pronounced in Meniere's disease ears than in normal ears. If was found that recovery of hearing loss after an attack was nearly identical each time it occurred in the same ear, but differed between ears and patients. This deterministic finding in the otherwise random course of the hearing loss as a function of time may be important in deciding what mechanisms cause fluctuating hearing loss in Meniere's disease.
Audiometry, Pure-Tone↗
Lithium treatment of meniere's disease. Results of a double-blind cross-over trial.
21 patients with Meniere's disease participated in a double-blind, cross-over trial, with 6 months' lithium treatment and 6 months' placebo treatment. Even if the results were not completely unequivocal, no difference was found between lithium and placebo treatment. The results might imply that both other medical as well as surgical treatment of Meniere's disease exert a pure placebo effect; so far no controlled investigation has been published, establishing the value of surgical treatment of Meniere's disease.
Clinical Trials as Topic↗
The role of dexamethasone or streptomycin perfusion in the treatment of Meniere's disease.
There is ample clinical and animal evidence that, in most patients, Meniere's disease is an immune-mediated disorder in a small, misplaced, malfunctioning endolymphatic sac that causes endolymphatic hydrops, the essential pathology of this disease. If this is so, then the potent anti-inflammatory steroids are the ideal first treatment for Meniere's disease and other immune-mediated diseases of the inner ear, and streptomycin perfusion is the ideal second treatment for those who do not respond to dexamethasone perfusion. The diagnosis, selection of patients, and details of operation with the results are presented. Results have been good with relief of dizzy spells and preservation of hearing in most patients after dexamethasone perfusion and relief of dizzy spells in those patients not responding to the dexamethasone perfusion by streptomycin perfusion.
Anti-Bacterial Agents↗
Otoadmittance changes following glycerol dehydration in Meniere's disease.
Otoadmittance studies were undertaken in 76 patients with Meniere's disease and 8 control subjects undergoing glycerol dehydration. Baseline otoadmittance values were significantly higher in ears with fluctuant hydrops compared to the non-fluctuant ears (p less than 0.01), suggesting that there is a pathophysiological difference between these clinical Meniere's groups. Significant maximum conductance changes were seen in 53.4% of hydroptic ears, and were associated with subjective audiometric threshold shifts in 23.2%. Similar changes were not seen in the control ears. These findings provide further clinical evidence to support an underlying physical basis for the auditory symptoms of endolymphatic hydrops and the effects of glycerol dehydration on the inner ear. Objective otoadmittance changes appear to be a more sensitive indicator of reversible hydrops than conventional audiometry. Possible mechanisms to explain the somewhat paradoxical increase in the resistance to the flow of sound energy through the cochlea following reduction of the endolymphatic hydrops by glycerol dehydration are discussed.
Adolescent↗
Bilaterality of Meniere's disease.
The audiometric configurations of a randomly selected group of 360 patients with clinical Meniere's disease were analysed in conjunction with their clinical manifestations. Although 78.6% of the patients had an abnormal pure-tone audiogram in the opposite ear from that which was initially diagnosed as Meniere's disease, based on the entire clinical picture, the disease was found to be definitely bilateral in 32% of the patients. A peaking audiogram type was found to be most common, occurring in about half of the involved ears. In approximately half of those with bilateral disease the second ear became involved within two years of onset of involvement of the first ear, and in another 27% the second ear became involved after a period of 5 years or more. These observations stress the importance of conservation in managing Meniere's disease, especially when considering surgical intervention for intractable disease, with the hope of retaining or restoring labyrinthine function.
Adolescent↗
The role of allergy in Meniere's disease.
There is considerable clinical and immunologic evidence for a probable role of allergy in the production of the symptoms of Meniere's disease. The endolymphatic sac is the seat of immune reactivity in the inner ear. Inhalant and food allergies have been linked with symptoms of Meniere's disease, and many of the clinical characteristics of Meniere's disease suggest an underlying autoimmune etiology. A significant percentage of patients with Meniere's disease and allergy show improvement in their symptoms of tinnitus and vertigo when receiving specific allergy therapy.
Antigens↗
[The control study of glycerol test in different stage of Meniere's disease patients].
OBJECTIVE: To investigate the best time of the glycerol test on Meniere's disease patients. METHOD: The glycerol test was carried out two times on 72 Meniere's disease patients, one time in the period of onset and the other in the period of intermission. RESULT: The positive rate in the period of onset (83.3%) was far higher than in the period of intermission(43.1%), additionally, the positive rate is irrelevant to the degree of hearing impairing or the course of disease. CONCLUSION: The glycerol test should be carried out in the period of onset as possible as you can to the suspicious patients.
Adult↗
Meniere's disease: evidence of an immune process.
OBJECTIVE: This study aimed to present further evidence of specific antibodies reactive against bovine inner ear proteins found in patients with Meniere's disease. BACKGROUND: There are a growing number of experimental and clinical features of Meniere's disease that indicate an immune association. Circulating antibodies directed against inner ear proteins have been detected in patients with bilateral progressive hearing loss and Meniere's disease. METHODS: A total of 36 patients with classical Meniere's disease were studied noting the presence of active or inactive, bilateral or unilateral disease. Bovine membranous labyrinth was used as inner ear extract and separated to molecular weights using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Western blotting included the addition of serum buffer (casein, Tween, and bovine serum albumins) and the use of alkaline phosphatase labeled anti-human immunoglobulin antibodies. RESULTS: The findings represent strong evidence of antibodies reactive to inner ear proteins. The incidence of these antibodies was correlated significantly with disease activity. CONCLUSIONS: The findings are further evidence of an immune process that is involved in Meniere's disease.
Adult↗
Meniere's disease: otologic concept and diagnosis.
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Humans↗
Endolymphatic sac surgery in Meniere's disease.
Despite the controversy that surrounds sac surgery for Meniere's disease, it remains in the forefront of surgical intervention for the refractory patient. This article reviews the literature for all types of sac surgery, with emphasis on wide sac-vein decompression as performed at the Michigan Ear Institute.
Cerebrospinal Fluid Shunts↗
Glycerol affects vestibular evoked myogenic potentials in Meniere's disease.
OBJECTIVES: to show that abnormal vestibular evoked myogenic potentials on the sternocleidomastoid muscle (SCM) in patients with unilateral Meniere's disease are caused by endolymphatic hydrops. SUBJECTS: six normal volunteers and 17 patients with unilateral Meniere's disease were examined. METHODS: click-evoked myogenic potentials were recorded with surface electrodes over each SCM. Responses evoked by clicks recorded after oral administration of glycerol (1.3 g/kg body weight) were compared with those recorded before administration. RESULTS: the change rate of the p13-n23 amplitude was calculated. The mean+standard deviation (S.D.) of the change rate was 3.52+14.6% in normal subjects. On the unaffected side of patients the change rates were within the normal range (within the mean+/-2S.D.) in 13 patients, and three ears showed significant decrease. Only one ear showed significant increase. On the affected side, five ears showed significant increase of the amplitude while two ears showed significant decrease after oral administration of glycerol. Effects on evoked myogenic potentials were independent of those on pure tone hearing. CONCLUSION: vestibular evoked myogenic potentials in some patients with unilateral Meniere's disease were improved by oral administration of glycerol. This result suggests that abnormal vestibular evoked myogenic potentials in patients with unilateral Meniere's disease could result from endolymphatic hydrops.
Administration, Oral↗