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Results for “MENIERE'S DISEASE”

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At least 487 records · Page 27Linked to original sources
PubMed2002

Expression of A, B, C and DR antigens in definite Meniere's disease in a Spanish population.

To analyze the associations of HLA class I and II antigens in patients with Meniere's disease (MD) in southern Spain, 54 patients with definite MD according to the diagnostic scale of the AAO-HNS were compared with 534 normal controls in a prospective multicenter study. We performed a serological typing for A, B, C and DR specificities of the major histocompatibility complex and allele-specific amplification for HLA-DRB1. No differences were found in the distribution of class I antigens or DR antigens in patients with definite MD when they were compared with the control group. Our results suggest that HLA antigens do not determine an increased susceptibility to develop MD.

Adult↗
PubMed1979

Histopathology of Endolymphatic subarachnoid shunt surgery for Meniere's disease.

The histopathological findings in the temporal bones of three patients who underwent endolymphatic subarachnoid shunt operation for Meniere's disease are reported. The postoperative follow-up period varied from three to five years. Two patients had a successful operation; the third was unsuccessful. The continuity between th mesothelial lining of the endolymphatic sac and the subarachnoid space was demonstrated in one case; no definite conclusions could be made for the other two cases. Although failure of shunt surgery was presumably due to fibrosis in the shunt area in the reported case, the human endolymphatic sac seemed to be more resistant to surgical trauma than the sac of the experimental animals.

Adult↗
PubMed1999

Electrocochleographic and audiometric evaluation of hypobaric effect in Meniere's disease.

OBJECTIVES: To elucidate the effects of hypobaric pressure on cochlear hydrodynamics in patents with well-defined Meniere's disease. DESIGN: Sixteen patients were consecutively selected. Elevated hearing threshold levels and pathological transtympanal electrocochleography (tt-ECOG) were confirmed at the day of trial. The patients were exposed to repeated episodes of hypobaric pressure in a pressure chamber. The rate (20 daPa/s) and magnitude (-285 daPa) of chamber pressure change were low. The induced tympanic overpressure (+185 daPa) was continuously monitored and any tympanic equilibration was avoided. METHODS: The results of Bekesy and speech audiometry as well as tt-ECOG performed immediately before and after exposure were compared. The importance of chamber pressure change, number of hypobaric episodes, duration of exposure, and the induced relative tympanic overpressure was tested. RESULTS: It is shown that the relative tympanic overpressure is the most important factor to affect the cochlear hydrodynamics. Higher relative overpressure was associated with improvement of hearing threshold levels, while the ECOG results tended to improve with lower induced tympanic overpressure. CONCLUSION: The importance of tympanic overpressure shown in this study is in agreement with previous findings from hypobaric animal experiments. The inverse relation of psychoacoustic and ECOG tests suggests that the two methods evaluate different parameters, perhaps contributing differently to the physiology of hearing.

Adult↗
PubMed1999

Direct round window membrane application of gentamicin in the treatment of Meniere's disease.

OBJECTIVE: To evaluate the effectiveness of the round window membrane (RWM) Gelfoam gentamicin technique in patients with Meniere's disease who were unresponsive to medical management or in whom surgical therapy failed. STUDY DESIGN: Protocol 1, single intratympanic gentamicin infusion; protocol 2 (the best method), 2 infusions, 5 days apart with reevaluation at 1 month; and protocol 3, multiple infusions 1 to 4 weeks apart. PATIENTS: In total, 32 patients (19 male, 13 female) were enrolled in the study. The mean age was 65 years (range 34 to 94 years). Seven of these patients were surgical salvage cases. INTERVENTIONS: Laser-assisted otoendoscopy with a 1.7-mm otoendoscope (Smith-Nephew Richards, Memphis, TN) was performed first. If the RWM was obscured by mucosa or adhesions, these were cleared before placing a 2 x 3 mm piece of dry Gelfoam against the RWM. Buffered gentamicin (26.7 mg/mL) was then injected into the middle ear (0.2 to 0.3 mL). RESULTS: Overall, vertigo was controlled in 75% of the patients after the completion of the treatment, with subtotal vestibular ablation in two thirds of patients. Hearing was preserved in 90% of the patients (within 15 dB pure-tone average or 15% speech discrimination score), tinnitus improved in 48%, and aural pressure improved in 62.5%.

Adult↗
PubMed1998

Subjective Visual Horizontal Determination During Otolith Stimulation by Eccentric Rotation in Conservatively Treated Meniere's Disease.

Peripheral vestibular equilibrium disorders may originate in various parts of the labyrinth or of the vestibular nerve. Traditionally, the function of the lateral semicircular canals has been assessed by caloric irrigation and has been interpreted (sometimes falsely) as demonstrating a vestibular nerve lesion. The vertical semicircular canals are not assessed easily. Caloric testing with the head in various positions is not very helpful, but the canals may be tested in pairs using specific rotational techniques. Often, the otolith organs, detecting linear acceleration forces, are forgotten as a source of vertigo and dizziness. The extent of otolith involvement in Meniere's disease is not well understood. The tested subject is seated eccentrically in a rotatory chair and faces the direction of rotation. Thus, the otolith organs are stimulated in steady-state rotation. The subject experiences a lateral tilt and, in darkness, is instructed to point a short light bar in the position that he or she thinks a water surface would have (identical to the perceived tilt). Patients with conservatively treated unilateral Meniere's disease were tested. In the eccentric rotation test, the patients with unilateral Meniere's disease showed highly variable, sometimes even paradoxical, responses. No correlation was noted between the eccentric otolith test and pure-tone audiometry or the side difference of the caloric responses. Otolith and lateral semicircular canal functions may differ in patients with Meniere's disease, the nature of which remains to be elucidated in further studies.

Journal Article↗
PubMed1998

Long-term hearing results following vestibular surgery in Meniere's disease.

OBJECTIVES: The purpose of this study is to evaluate the long-term hearing changes following vestibular surgery in patients with Meniere's disease. STUDY DESIGN: This is a retrospective analysis of patients operated on in a tertiary referral center setting. METHODS: Preoperative, postoperative, and 3- to 9-year postoperative audiograms were analyzed in two patient groups. Twenty-one patients underwent posterior fossa vestibular neurectomy (VN) and five, mastoid endolymphatic sac decompression and shunt (ELS). All frequencies, four-frequency pure-tone averages (PTAs), spondee thresholds, and speech recognition scores were compared for operated ear against nonoperated ear of VN subjects. The results were subjected to a covariance analysis. VN and ELS patients whose hearing deteriorated from "serviceable" (PTA < or =70 dB hearing level) and speech recognition > or =30%) to nonserviceable status were compared using nonparametric statistics. RESULTS: Progressive hearing loss beyond the rate of change of the normal contralateral ear was evident in all patients. Serviceable hearing dropped from 81% to 43% of patients an average of 4 years following VN. CONCLUSIONS: VN patients have significant hearing deterioration over time in the operated ear. This finding suggests that continued postoperative medical management is necessary for patients undergoing VN.

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