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PubMedDate not supplied

Heat exchange in cryosurgery of Meniere's disease. Experimental and clinical studies.

The course of the temperature in the lateral semicircular canal and the heat exchange were measured on temporal-bone specimens when cooling with a cryoprobe on the lateral semicircular canal was performed. The measurements showed a correlation between the heat exchange, the cooling time and the temperature in the lateral semicircular canal. In 15 patients with unilateral Meniere's disease, this was utlized to achieve a controlled temperature course during cryosurgery on the lateral semicircular canal. The effect of the treatment on the attacks of vertigo and on the hearing in these patients is reported.

Cryosurgery↗
PubMed1999

Recognition of a dominant epitope in bovine heat-shock protein 70 in inner ear disease.

OBJECTIVE: To investigate the specificity of antibodies to heat-shock protein 70 (HSP70) in patients with idiopathic, progressive, bilateral sensorineural hearing loss (IPBSNHL) and Meniere disease. STUDY DESIGN: Test immunoreactivity of patients' sera using recombinant human (rh) and bovine (rb) HSP70, as well as segments representing different regions of bovine HSP70 as antigen. METHODS: Sera were tested by Western blotting. RESULTS: Of 52 patients with IPB-SNHL, 40 sera reacted only with rbHSP70; 12 reacted with both rbHSP70 and rhHSP70. Sera from 13 patients with IPBSNHL and from 8 with Meniere disease were tested on the panel of bovine HSP70 segments. Eleven and 7 samples, respectively, reacted with amino acid segment 427-461 from the carboxy (C)-terminal region of the molecule. CONCLUSION: In IPBSNHL and Meniere disease, antibodies are directed primarily against an epitope(s) within the C-terminal region of HSP70 where diversity in sequence among different species, including possible pathogens, is greatest. These findings may provide clues to the pathogenesis or specific serodiagnosis (or both) of diseases of the inner ear.

Animals↗
PubMed2001

[Changes in otoacoustic emission during the glycerol test in the ears of patients with Meniere's disease].

Monitoring of cochlear function is one proposed clinical application of otoacoustic emission (OAE). To determine the clinical utility of OAE in monitoring, we studied changes in OAE during the glycerol test used to diagnose endolymphatic hydrops. Transiently evoked OAE (TEOAE) and distortion product OAE (DPOAE) were measured before and 3 hours after oral administration of glycerol in 22 ears of patients with Meniere's disease. The positive result in the glycerol test was observed in 11 of 22 ears. TEOAE was recorded using a nonlinear click stimulus, and total echo power (TEP) of the whole response and filtered echo power (FEP) of its mid-frequency (1000-2000 Hz) component were used as TEOAE parameters. The growth functions of DPOAE were recorded at 3 F2 frequencies--1000, 1500, and 2000 Hz. Changes in the growth function were determined based on changes in 2 parameters--maximum level and detection threshold of DPOAE. When changes in these 4 parameters exceeded 2 standard deviations above mean test-retest variability determined from OAE data for 17 normal ears, they were considered significant. Significant changes indicating improved cochlear function in 4 OAE parameters or the appearance of OAE during the glycerol test were judged positive for OAE. Regardless of glycerol test results, positive findings were observed in both OAEs whenever a pure-tone threshold at 1000 or 2000 Hz improved. However, even in ears for which pure-tone thresholds at these frequencies did not improve, both OAEs frequently exhibited positive findings. In all ears with a positive result in the glycerol test, positive findings were observed in DPOAE, but not in TEOAE. Of the 2 parameters of TEOAE, FEP always exhibited a positive finding in ears with a positive TEP finding and FEP positivity was higher than that of TEP. In DPOAE, no cases showed a positive finding only at F2 = 2000 Hz, and DPOAE at F2 = 1000 Hz could not be detected in 4 ears due to high noise floor. Overall, positive findings were obtained in 14 ears (63.9%) for TEOAE and 20 ears (90.9%) for DPOAE. In only 1 ear were no positive findings observed in either OAE. The sensitivity of OAE measurement as a diagnostic test for endolymphatic hydrops was higher than that of pure-tone audiometry. Of the 2 OAEs, test sensitivity was much higher for DPOAE than for TEOAE. These results show that OAE measurement detects changes in cochlear function during the glycerol test more sensitively than pure-tone audiometry. They also suggest that FEP is a better indicator than TEP as a parameter of TEOAE, and that DPOAE measurement at F2 = 1000 and 1500 Hz is sufficient for practical clinical use. However, of the 2 OAEs, DPOAE was considered more appropriate than TEOAE for monitoring during the glycerol test because of its high sensitivity in detection of changes in cochlear function. In conclusion, clinical use of OAE, especially DPOAE, as a test complementary to pure-tone audiometry during the glycerol test is very useful and will improve the diagnosis of endolymphatic hydrops.

Adult↗
PubMed1997

Benign recurrent vertigo--true or artificial diagnosis?

The etiology of many diseases involving vertigo is still unknown although the same etiologic factors have been suggested for several diseases. In most cases the diseases are diagnosed on the basis of exclusion-other possible causes being ruled out before the diagnosis can be confirmed. Benign recurrent vertigo (BRV) has been defined as spells of vertigo characteristic of Menieres disease without auditory or clinical neurologic symptoms and signs. The etiology of this condition is also unknown. BRV has been linked to migraine and viral diseases. In a prospective study we collected the clinical history and the signs and results of neurotologic and audiologic tests from 33 patients with a BRV diagnosis. The clinical characteristics truly mimicked the vertigo seen in Menieres disease. The concept of vestibular Menieres disease is not widely accepted, and without auditory signs BRV is the only diagnosis that can be given to these patients. In other studies up to 25% of the patients initially diagnosed with BRV subsequently developed another peripheral vestibular disorder. Until the etiology of diseases involving vertigo is more clearly understood, artificial diagnoses like BRV, must be accepted.

Adult↗
PubMed1983

Vascular mechanisms in Meniere's disease.

Normal venous drainage of the vestibular organs through the vein of the paravestibular canaliculus (PVC) may be crucial to inner ear fluid mechanics. It is proposed that increased venous pressure, with resultant venous insufficiency of the vestibular organs, may result in endolymphatic hydrops unless collateral venous circulation develops. Certain variations in pattern of venous drainage where the vestibular organs drain predominantly through the PVC vein may be a predisposing factor. In patients with Meniere's disease, different mechanisms can cause venous insufficiency. One suggested mechanism is morphologic change in the microcirculation of the intermediate portion of the endolymphatic sac. Microcirculation changes may be associated with fibrosis of the perisac tissues or shortening of the intermediate sac region or might be physiologically determined. Venous insufficiency may also result from anomalies of the PVC vein.

Ear, Inner↗
PubMed2006

[Arachnoid cyst of cerebellar-pontine angle clinically mimicking Meniere's disease].

Arachnoid cysts represent about 1% of all intracranial space-occupying lesions. Usually they are located in the middle cranial fossa while their localization in the posterior fossa is uncommon and generally remain asymptomatic or those are non-specific. The case of a 51 years old female is reported who was diagnosed by IRM of a 4,5 x 2 cm arachnoid cyst, situated on the left cerebello-pontine angle, with tinnitus, hearing loss and vertigo that mimicked a Meniere's attack. We think thees benign tumors must be included in the differential diagnosis of Meniere's disease because they can be indistinguishable from it clinically.

Arachnoid Cysts↗