MENIERE'S syndrome and Meniere's disease--terminology, management.
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Disease Management↗
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Results for “MENIERE'S DISEASE”
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[New possibilities in the treatment of Meniere's disease].
The results of the treatment of Meniere's disease by intratympanic instillation of gentamicin in 32 patients over a 24-months period were analyzed. The receded vestibular function was found in 96.8% patients, whereas in the remaining 3.2% pronounced vestibular hypofunction was observed. One month after the treatment vertiginous attacks disappeared in all the patients. However, three months after the treatment infrequent episodes of mild degree vertigo and mild unsteadiness that did not require additional intratympanic gentamicin application appeared in 15% of the patients with Meniere's disease. The vertiginous attacks ceased or were pronouncedly reduced in 85% of the patients. The unstable vestibular hypofunction was successfully converted into stabilized, centrally compensated areflexia. Intratympanic gentamicin exerted better results than the other invasive therapies for intractable Meniere's disease.
Anti-Bacterial Agents↗
Intratympanic gentamicin in Meniere's disease.
Ninety-three patients with intractable Meniere's disease were treated with gentamicin (Garamycin 40 mg/ml) administered in 1 to 4 transtympanic injections. The patients were tested at frequent intervals and followed up for 2 years. Before treatment all subjects experienced moderate or severe handicap caused by Meniere's disease. Two years after the treatment, rotatory vertigo was abolished in 81% of subjects, Tumarkin attacks were cured in 60%, and work capacity was severely reduced in 10% and moderately reduced in 17% of subjects. The outcome of the caloric responses did not correlate with the outcome of the treatment. In logistic regression analysis poor outcome of treatment correlated with Tumarkin attacks (odds ratio 5.5), severity of vertigo (odds ratio 3.8) and gait disorders (odds ratio 2.9). The mean hearing level was significantly affected by the treatment (before, 59.1 dB HL; after, 67.9 dB HL). Ten treated ears became deafened. During follow-up 44 subjects were subjected to retreatment, usually after 6 months. Intratympanic gentamicin treatment is a relatively safe and effective way to treat Meniere's disease. The authors recommended starting with 2 injections and renewing the injections if relapse occurs.
Adult↗
[Meniere's disease and the cervical spine].
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Cervical Vertebrae↗
A Meniere's disease gene linked to chromosome 12p12.3.
Meniere's disease (MD) is characterized by spontaneous attacks of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The majority of patients with MD appear sporadic but 5%-13% of the cases have a family history for the disease. The cause of both the sporadic and inherited forms of MD remains unclear despite a number of candidate genes defined from their association with hearing loss. We have performed a genome wide linkage scan on a large Swedish family segregating MD in five generations. Five candidate regions with a lod score of >1 were identified. Two additional families with autosomal dominant MD were analyzed for linkage to these regions and a cumulative Z(max) of 3.46 was obtained for a single region on chromosome 12p. In two of the three families, a shared haplotype was found to extend over 1.7 Mb which suggests a common ancestral origin. Within this region, a single recombination event restricts the candidate region to 463 kb.
Chromosome Mapping↗
The temporal bone in patients with Meniere's disease.
Sixty-three patients with Meniere's disease were compared with a group of healthy individuals with respect to findings at tomography and plain radiography. The temporal bone in patients differed in many respects from that in the healthy controls. Characteristic features in patients were a lack of periaqueductal pneumatization, a lack of pneumatization medial to the arcuate eminence, a short vestibular aqueduct, a narrow external aperture of the vestibular aqueduct, and a reduction in size of the mastoid air cell system. The mean mastoid area in the diseased ear in patients was 7.93 cm2 and in controls 11.59 cm2. The vestibular aqueduct was visible in its full length on tomograms in 81% of the healthy controls and in 65% of the diseased ears in patients. The mean volume of the mastoid air cell system in Meniere patients, determined at operation, was 5.3 ml.
Adolescent↗
[The characteristics of Meniere's disease in aircrew].
OBJECTIVE: To study the characteristics of Meniere's disease in aircrew and its possible influence on space flight. METHOD: Case studies of Meniere's disease were carried out in 22 pilots. RESULT: There were vertigo (n=22), tinnitus (n=21), abnormal hearing (n=19) and abnormal vestibular function (n=11) in 22 pilots. CONCLUSION: Meniere's disease may hazard the flying in aviation or space and flying may further damage the inner ears of patients with Meniere's disease.
Aerospace Medicine↗
Bilateral Meniere's disease.
A survey of 265 Japanese patients with Meniere's disease revealed bilateral involvement in approximately 29% of all these patients. Somatic and psychiatric aspects of bilateral Meniere's disease were as follows. (1) The duration of the disease in cases of bilateral involvement was significantly longer than cases of unilateral involvement. (2) An abnormal general condition, a more extensive degree of hearing loss and neurotic type were frequently diagnosed in cases of bilateral involvement. Based on these results, it was concluded that psychiatric management and prevention of aggravation of deafness should be part of the management of treatment in bilateral Meniere's disease.
Female↗
[Significance of some otologic function tests in diagnosis of Meniere's disease].
OBJECTIVE: To investigate the significance of vestibular function battery and electrocochleogram on diagnosis of Meniere's disease. METHOD: Patients with Meniere's disease were given pure tone hearing threshold test, auditory brainstem responses (ABR), electrocochleogram (ECoG), vestibular bithermal caloric test and vestibular evoked myogenic potentials (VEMP) test. RESULT: (1) As for the bithermal caloric test, the percentage of the abnormal canal paresis (CP) at three durations, i.e. , 0 to approximately 5 years, 6 to approximately 10 years and over 11 years were 56.9%, 75.9% and 61.6% respectively. The total positive rate was 50.0%. CP and duration of Meniere's disease had low correlation (P < 0.05). (2) The percentage of the abnormal VEMP at three durations, i.e., 0-5 years,6-10 years and over 11 years were 57.4%, 60% and 57.1% respectively. The total positive rate was 58.0%. The duration of Meniere 's disease with normal and abnormal VEMP had no significant difference( P >0.05). (3) The percentage of the abnormal ECoG at three durations, i.e., 0-5 years, 6-10 years and over 11 years were 72.1%, 73.3% and 81.3% (49/68,22/30 and 13/16) respectively. The total positive rate was 76.9%. The duration of Meniere's disease with normal and abnormal ECoG had no significant difference (P >0.05). CONCLUSION: Diagnosis of Meniere's disease is mainly based on the medical history. If it could combine with ECoG, bithermal caloric test and VEMP, the diagnosis would be earlier and more accurate.
Adolescent↗
Management of Meniere's disease. Surgery may help if medication fails.
Meniere's disease is the classic triad of fluctuating hearing loss, episodic vertigo, and severe tinnitus. It usually occurs unilaterally, although about 15% to 20% of patients may have bilateral disease. The disease involves a series of acute exacerbations followed by a period of remission; it progresses until the ear has essentially "burned itself out," causing symptoms to subside. Treatment of Meniere's disease should be tailored to the severity of symptoms and the patient's life-style. Initial treatment involves conservative medical management and psychologic support. If this fails, endolymphatic shunt surgery is effective in alleviating symptom in the majority of patients.
Ear, Inner↗
Association of HLA-DR and type II collagen autoimmunity with Meniere's disease.
To investigate HLA-associated genetic susceptibility to Meniere's disease in relation to type II collagen (CII) autoimmunity status, HLA-DRB1 genotyping and ELISA measurement of anti-CII antibody were performed in 41 Korean patients with Meniere's disease. In the anti-CII positive subgroup (20%) of patients, the frequency of HLA-DRB1*0405 was significantly increased (uncorrected) compared with both controls (63% vs 16%) and anti-CII negative patients (63% vs 12%). In the anti-CII negative subgroup, HLA-DRB1*1201 was significantly increased (uncorrected) (27% vs 10%) and DRB1*13 was decreased (6% vs 24%) compared with controls; these alleles appeared to confer susceptibility and resistance to the development of the disease. Association of HLA-DRB1*0405 with anti-CII positive Meniere's disease in this study suggests that it shares a specific HLA-DR sequence, QRRAA, as a genetic susceptibility factor with the anti-CII positive rheumatoid arthritis. In conclusion, whilst type II collagen autoimmunity may have a partial role in Meniere's disease, different HLA-DR alleles may also be associated with either susceptibility or resistance to the development of the disease in relation to anti-CII antibody status.
Adult↗
[Pathogenetic and therapeutic considerations on the peripheral vertiginous syndrome (Meniere's disease)].
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Humans↗
[Meniere's syndrome. Meniere's disease and allied diseases].
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Humans↗
Pressure sensation in Meniere's disease.
This article reports a case of Meniere's disease accompanied by a persistent feeling of pressure in the ear. The patient had undergone a series of surgical procedures to alleviate his symptoms. The pressure sensation was relieved only by translabyrinthine cochlear nerve section. The relationships of the result of translabyrinthine cochlear nerve section with the mechanism and pathway of the pressure sensation are discussed. Cochlear nerve section is recommended at the same time as vestibular nerve section for patients with unilateral Meniere's disease with severe pressure sensation in the ear.
Adult↗
The spectrum of audiologic and vestibular findings in patients with Meniere's disease.
A retrospective study of 55 patients with Meniere's disease suggested a subgrouping based on presentation of auditory symptoms. Patients were defined as "definite" (documented fluctuating hearing loss and episodic vertigo), "probable" (history of fluctuating hearing loss and episodic vertigo) and "possible" (history of fluctuating tinnitus and episodic vertigo). An in-depth discussion of the natural history, audiometric and vestibular findings is presented.
Adult↗
Intratympanic gentamicin for unilateral Meniere's disease: results of therapy.
Patients with Meniere's disease that remains refractory to conservative treatment have traditionally been subjected to ablative surgery. The purpose of this prospective study was to evaluate the use of intratympanic gentamicin in eliminating incapacitating vertigo, while preserving hearing. Over the past 8 years, 83 patients have received between 1 and 6 intratympanic injections of gentamicin in an out-patient setting, with duration of therapy titrated to individual symptom response and effect on hearing. Using established AAO-HNS guidelines, we present data on 50 patients who have a minimum of 2 years follow-up. Control or significant improvement of definitive Meniere's attacks was achieved in 92% of patients and hearing preserved or improved in 76%. Only one patient experienced profound sensorineural hearing loss. We feel this treatment option should be considered and offered to patients in whom medical treatment has failed.
Adult↗
Results of endolymphatic sac surgery in advanced Meniere's disease.
A rational surgical approach to Meniere's disease eludes us because of the uncertainty of the pathophysiology and the variability in the natural history of the disease. The results of different surgical techniques are difficult to compare because of differences in patient selection, methods of analysis, and length of follow-up reported. This study reviews long-term results in twenty-four ELS procedures in which the test group and parameters of evaluation are carefully described. The overall rate of vertigo control is 75 percent and incidence of significant hearing improvement is 25 percent. This low rate of hearing improvement is related to the selection of patients with advanced disease and other factors. In this series, surgery limited to simple decompression of the ELS proved generally more effective than shunt procedures. It is noteworthy that the Arenberg valve implant provided impressive results in a small number of revisions. Postoperative fibrosis appears to affect results adversely, therefore, measures to prevent scar tissue proliferation seem indicated.
Cicatrix↗
Genetic basis of familial Meniere's disease.
The genetic basis of familial Meniere's disease (MD) is unclear. We present a genetic investigation of six individuals in two families with familial MD. Linkage analysis was performed using polymorphic DNA markers linked to the human leukocyte antigen (HLA) locus that map to chromosome 6p. We have demonstrated the presence of anticipation in successive generations and the absence of HLA association. This is the second report of anticipation in familial MD in the literature, and it suggests that efforts should be directed toward finding a trinucleotide expansion as a possible genetic lesion in this uncommon disorder.
Adolescent↗