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PubMed2003

Symptom relief after treatment of temporomandibular and cervical spine disorders in patients with Meniere's disease: a three-year follow-up.

This study describes the coordinated treatment of temporomandibular disorders (TMD) and cervical spine disorders in patients diagnosed with Meniere's disease. The aim was to follow up treatment outcomes for three years with regular follow-up examinations every six months. Of the 31 patients with Meniere's disease who participated in a controlled comparative study on the signs and symptoms of TMD, 24 participated in a subsequent controlled comparative study on the signs and symptoms of cervical spine disorders (CSD). These 24 Meniere's disease patients (ten males and 14 females) agreed to participate in this longitudinal study. At each follow-up, their symptoms were evaluated using self-administered questionnaires and visual analog scales (VAS). The results of the coordinated treatment showed simultaneous decreases in the intensities of vertigo, nonwhirling dizziness, tinnitus, feeling of fullness in the ear, pain in the face and jaws, pain in the neck and shoulders, and headache that were both longitudinal and highly significant. Significant longitudinal reductions in the frequencies of vertigo, nonwhirling dizziness, and headache were also reported by the patients as well as a complete disappearance of pain located in the vertex area. A significant relief of TMD symptoms and a decrease in nervousness was also achieved. The results showed that a coordinated treatment of TMD and CSD in patients with Meniere's disease is an effective therapy for symptoms of this disease. The results also suggested that Meniere's disease has a clear association with TMD and CSD and that these three ailments appeared to be caused by the same stress, nervousness, and muscular tension.

Adult↗
PubMed2000

Intratympanic gentamicin for the treatment of unilateral Meniere's disease.

OBJECTIVE: To determine the efficacy of intratympanic gentamicin instillation as treatment of incapacitating unilateral Meniere's disease, using a predetermined regimen with a fixed dose. STUDY DESIGN: A prospective study from a single institution between 1988 and 1998. METHODS: One hundred fourteen patients were enrolled in this study. Gentamicin (26.7 mg/mL) was administered three times daily for 4 consecutive days. The Committee on Hearing and Equilibrium Guidelines for Reporting Treatment Results in Meniere's Disease of the American Academy of Otolaryngology and Head and Neck Surgery (1985) were used. RESULTS: Comprehensive data were available for 90 individuals. Complete control of vertigo was achieved in 76 (84.4%), substantial control in 8 (9.0%), limited control in 2 (2.2%), and insignificant control in 4 (4.4%) patients. Disability scores at the end of 2 years were as follows: 76 patients (84.4%) had no disability, 5 (5.6%) had mild disability, 2 (22%) had moderate disability, and 7(7.8%) had severe disability. Caloric testing responses, as determined using electronystagmography, were as follows: 71% of the patients had an absent ice-water response, 16% had a positive ice-water response, and in 13% there continued to be present a bithermal response. Hearing was worse in 22 patients (25.6%), unchanged in 41 (48.2%), and improved in 22 (25.6%). CONCLUSIONS: Intratympanic gentamicin administration using this particular protocol is an effective treatment option for patients with disabling unilateral Meniere's disease. Hearing loss is a distinct possibility, and patients should be advised accordingly.

Adult↗
PubMed2006

Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere's disease.

The objective was to investigate vestibular evoked myogenic potentials (VEMP) in benign paroxysmal positional vertigo (BPPV) and Meniere's disease, and to determine if this type of testing is valuable for assessing the vestibular system. A prospective controlled clinical study was designed in a tertiary referral center setting. The 62 participants included 17 healthy controls and 45 other subjects selected from patients who presented with the complaint of vertigo (25 diagnosed with BPPV and 20 diagnosed with Meniere's disease). The main outcome measures of VEMP were recorded in all subjects and findings in each patient group were compared with control findings. The VEMP for the 30 affected ears in the 25 BPPV patients revealed prolonged latencies in eight ears and decreased amplitude in one ear (nine abnormal ears; 30% of total). The recordings for the 20 affected ears in the Meniere's disease patients revealed four ears with no response, six ears with prolonged latencies (ten abnormal ears; 50% of total). Only two (5.9%) of the 34 control ears had abnormal VEMP. The rate of VEMP abnormalities in the control ears was significantly lower than the corresponding rates in the affected BPPV ears and the affected Meniere's ears that were studied (P=0.012 and P<0.001, respectively). The results suggest that testing of VEMP is a promising method for diagnosing and following patients with BPPV paroxysmal positional vertigo and Meniere's disease. Further investigations with this method in other neurotologic pathologies might also be informative.

Adult↗
PubMed1980

Update on the use of streptomycin therapy for Meniere's disease.

An update of our experiences in the treatment of Meniere's disease with intramuscular streptomycin sulfate reveals great success in relief of episodic vertigo. Hearing losses that existed before the treatment are generally stabilized and occasionally improved. Because of the considerable morbidity caused by arduous therapy, prolonged ataxia, and occasional oscillopsia, we recommend that the treatment be reserved for the bilateral disabling form of the disease.

Adult↗
PubMed1998

Use of glycopyrrolate in the treatment of Meniere's disease.

OBJECTIVES/HYPOTHESIS: The objective of this study was to determine whether glycopyrrolate is useful as a vestibular suppressant in patients with Meniere's disease. The tested hypotheses were that glycopyrrolate would decrease the perception of dizziness measured by the Dizziness Handicap Inventory in patients with Meniere's disease and that placebo would cause no such decrease. STUDY DESIGN: Randomized, prospective. METHODS: Thirty-seven subjects with a diagnosis of Meniere's disease were administered either 2 mg of glycopyrrolate or placebo twice daily as needed for vertigo. All were also administered the regimen of 1500 mg sodium/day diet and diuretic. The following indices were examined: Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Modified Somatic Perception Questionnaire, Beck Depression Inventory, hearing examination, and electronystagmography. After 4 to 6 weeks of the drug regimen, Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Modified Somatic Perception Questionnaire, and Beck Depression Scale were reexamined. Paired t tests were performed to verify the significance of improvement before and after treatment. RESULTS: Subjects who received glycopyrrolate had statistically significant reduction in Dizziness Handicap Inventory, Beck Depression Score, and Modified Somatic Perception Score. In the placebo group, no improvement in any index was found. CONCLUSIONS: The hypothesis that glycopyrrolate is a useful vestibular suppressant in patients with Meniere's disease was statistically verified.

Adult↗
PubMedDate not supplied

The vestibular aqueduct in Meniere's disease.

The vestibular aquaeduct was evaluated blindly in tomograms from patients with Meniere's disease or chronic otitis and from patients without ear disorders. The descending part of the aquaeduct was clearly visible in 95% of the patients without ear disease. In the two other groups, it was visible only in about 50%. It is suggested that a narrow or invisible vestibular aquaeduct is an unspecific radiological sign in a variety of ear diseases.

Adolescent↗
PubMed1985

Comparison between electrocochleography and glycerol test in the diagnosis of Meniere's disease.

Electrocochleography (ECoG) and glycerol test were performed in 51 Meniere ears. The positive rate of both tests was compared. The positive rate of ECoG and glycerol test was 63% and 51%, respectively. The ears with positive result of both tests and of either test were 15 of 51 ears (29%) and 43 of 51 ears (84%), respectively. The positive rate of ECoG was higher in ears with a moderate to severe hearing loss at high frequencies, while the positive rate of glycerol test was higher in ears with a moderate to severe hearing loss at low frequencies. The present study has demonstrated that ECoG is different in selectivity of detection of the endolymphatic hydrops from glycerol test and that the combination of both tests increases the detection rate of the endolymphatic hydrops in Meniere's disease.

Adult↗
PubMed1984

Titration streptomycin therapy for bilateral Meniere's disease: a preliminary report.

Intramuscular dosages of streptomycin sulfate were titrated in eight patients with bilateral Meniere's disease in an attempt to alleviate disabling vertigo and hearing loss. It appears possible to eliminate the vertiginous episodes, preserve or improve hearing, and avoid ataxia and oscillopsia in most of these individuals. At present we consider this treatment regimen our first choice of therapy in people with bilateral active Meniere's disease or in patients whose only hearing ear is actively fluctuating and in whom associated disabling vertigo is present. Great caution and supervision should be exercised in the use of streptomycin titration therapy in the individual with bilateral Meniere's disease, as further experience is required to determine the efficacy of this form of management.

Adult↗
PubMed1977

Eustachian tube blockage and Meniere's disease.

On the basis of our clinical experience, it has been noted that an unusually large proportion of patients with Meniere's disease have intermittent eustachian tube blockage. A review of the tympanograms of 81 patients with Meniere's disease, representing 107 ears, showed that 25 (30.9%) of the patients and 35 (32.7%) of the ears had abnormal negative middle ear pressure. The maximum compliance peak was in at a pressure point in excess of --100 mm H2O. Further investigation of these patients has led us to conclude that intermittent eustachian tube blockage frequently accompanies Meniere's disease, yet it is not necessarily the cause of the symptomatic disorder.

Adult↗
PubMed1999

Saccular dysfunction in Meniere's disease.

OBJECTIVE: The aim of this study was to assess any dysfunction of the sacculus in patients with unilateral Meniere's disease by monitoring the vestibular evoked myogenic potentials (VEMPs) evoked by high level clicks on the Stemomastoid muscles (SCMs). STUDY DESIGN: The study was a retrospective analysis. SETTING: The study was performed in the E.N.T. department of the Lariboisière Hospital. PATIENTS: Fifty-nine patients aged 18 to 74 years with well-established unilateral Meniere's disease were included in the study. INTERVENTIONS: Loud monaural clicks were delivered unilaterally, and the VEMPs were recorded with skin electrodes on the ipsilateral SCM. All the patients were also subjected to a pure tone audiometric test and bithermal caloric testing. The postural performances of 39 patients were analyzed using the Equitest. MAIN OUTCOME MEASURE: VEMP results were the main outcome measure. RESULTS: The saccular response was absent on the affected side in 54% of the patients with Meniere's disease. This absence was correlated with the degree of low frequency hearing loss but not with canal paresis. Finally, nonfalling patients with saccular dysfunction had a significantly poorer postural performance than those without such dysfunction in the condition 5. CONCLUSION: Patients with Meniere's disease could have a saccular dysfunction (54% in this series). This saccular impairment correlated with low frequency hearing loss but not with canal paresis. Patients without VEMPs had poorer postural performances in condition 5 than those with normal VEMPs. Therefore, VEMP testing is useful for detecting patients at risk: in patients with saccular lesion, the dynamic postural performances should be assessed on a movable platform to detect visually dependent patients and to orient vestibular rehabilitation.

Adolescent↗
PubMed1981

Unrecognized infantile Meniere's disease.

We have described two patients who, from early infancy, suffered attacks of vomiting associated with fluctuating hearing loss, which ended in bilateral severe sensorineural hearing loss. The patients were treated by pediatricians as suffering from gastroenteritis or meningitis. Meniere's disease was not suspected. We want to point out that Meniere's disease, though it usually begins in middle age, may well start in childhood, as well as in infancy, and should be suspected whenever vomiting without diarrhea is associated with some hearing loss at any age--no matter how young the patient is. It is also quite possible that some sensorineural hearing losses in late childhood or adulthood are in effect the result of early burnt-out Meniere disease, as in our second case.

Deafness↗