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Otol Neurotol 2022 04;43(4):e529

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Vestibular nerve section (VNS) is a surgical intervention with hearing preservation used for the treatment of Menière's disease after conservative medical therapy has failed (1,2). With the recent rise in less invasive treatments such as intratympanic gentamicin, VNS has been performed less frequently (3). The middle cranial fossa (MCF) approach for VNS is an uncommon approach due to its technical difficulty. Read More

Acta Otorhinolaryngol Ital 2022 Feb 7;42(1):89-96. Epub 2022 Feb 7.

Medical Toxicology-headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Objective: This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière's disease and comorbid temporomandibular joint disorder.

Methods: The results of a battery of audiometric and vestibular tests were recorded before and after 6 months of treatment, as well as the scores of disease-specific questionnaires.

Results: The average hearing threshold in the affected ear and the acoustic immittance were unchanged. Read More

Otol Neurotol 2022 02;43(2):263-267

Otolaryngology Department, Verona University Hospital, Verona, Italy.

Objective: Ménière's disease is an idiopathic inner ear disorder characterized by recurrent vertigo, fluctuating sensorineural hearing loss, and persistent tinnitus. In 10% to 30% of cases, conservative therapy fails, and Ménière's disease is defined as intractable. In these patients, ablative techniques with unilateral vestibular deafferentation are mandatory. Read More

Front Neurol 2021 23;12:794741. Epub 2021 Dec 23.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.

Meniere's disease is an inner ear disorder without a known cause. Endolymphatic hydrops is a swelling of the endolymph spaces that has been observed consistently on post-mortem histology in patients with a history of Meniere's disease but can occur in asymptomatic individuals and in association with other diseases. Since its discovery, Meniere's disease has been a disorder managed primarily by otolaryngologists. Read More

Auris Nasus Larynx 2022 Aug 20;49(4):584-592. Epub 2021 Dec 20.

Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland.

Objectives: The aim was to evaluate endolymphatic hydrops in patients with Ménière's disease before and after vestibular neurectomy to verify if the endolymphatic space dilatation, observed in magnetic resonance imaging, regressed within several months after surgery.

Methods: Magnetic resonance imaging was performed after intravenous gadolinium injection in four patients with unilateral definite Ménière's disease before and eight months after vestibular neurectomy. Clinical symptoms, audiovestibular tests, and endolymphatic hydrops in magnetic resonance imaging were evaluated. Read More

J Otolaryngol Head Neck Surg 2021 Dec 20;50(1):70. Epub 2021 Dec 20.

Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.

Background: To explore the differences between endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in the reversal of endolymphatic hydrops (EH) in patients with intractable Meniere's disease (MD).

Methods: A total of 27 MD patients receiving endolymphatic duct blockage surgery (n = 10), endolymphatic sac drainage surgery (n = 9) and endolymphatic sac decompression surgery (n = 8) underwent gadolinium-enhanced inner ear magnetic resonance imaging (MRI) scans prior to, 2 weeks after and at > 12 months following surgery.

Results: In the group with endolymphatic duct blockage, the second MRI revealed no changes in EH, whereas the third MRI revealed a reversal of vestibular EH in 3 patients and a downgrading of cochlear hydrops in 2 of these 3 patients, who presented with an improvement in their hearing and complete control of vertigo. Read More

Otol Neurotol 2022 01;43(1):113-119

Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea.

Objective: To describe a novel approach for intractable Ménière's disease exclusively through a transcanal endoscopic ear surgery (TEES) approach.

Patient: A 56-year-old male with intractable Ménière's disease despite conservative treatment and chemical labyrinthectomy.

Interventions: Transcanal endoscopic labyrinthectomy. Read More

J Laryngol Otol 2022 Feb 29;136(2):125-128. Epub 2021 Nov 29.

Department of Otorhinolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, Scotland, UK.

Objective: To determine the short- and long-term outcomes of triple semicircular canal occlusion as a potential alternative for patients with intractable Ménière's disease.

Methods: A retrospective case series was performed in university settings, enrolling patients with intractable Ménière's disease with previous maximum treatment, who underwent transmastoid, triple semicircular canal occlusion. The study documented: pre- and post-operative Dizziness Handicap Inventory scores at six weeks and one year post-treatment, pure tone audiometry, and surgical aspects. Read More

Clin Otolaryngol 2022 03 28;47(2):319-322. Epub 2021 Nov 28.

Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China.

BMJ Open 2021 08 10;11(8):e054514. Epub 2021 Aug 10.

Department of Otorhinolaryngology, Haga Hospital, The Hague, The Netherlands.

Introduction: Outcomes of surgery for Ménière's disease (MD) remain discordant. Recently, a new surgical procedure in which the endolymphatic duct is clipped was proposed. To date, only one prospective trial assessing this technique was published, yielding promising results. Read More

J Extracell Vesicles 2021 06 4;10(8):e12094. Epub 2021 Jun 4.

Department of Transfusion Medicine University Hospital Salzburger Landeskliniken GesmbH (SALK) and Paracelsus Medical University (PMU) Salzburg Austria.

Extracellular vesicles (EVs) derived from the secretome of human mesenchymal stromal cells (MSC) contain numerous factors that are known to exert anti-inflammatory effects. MSC-EVs may serve as promising cell-based therapeutics for the inner ear to attenuate inflammation-based side effects from cochlear implantation which represents an unmet clinical need. In an individual treatment performed on a 'named patient basis', we intraoperatively applied allogeneic umbilical cord-derived MSC-EVs (UC-MSC-EVs) produced according to good manufacturing practice. Read More

Otol Neurotol 2021 09;42(8):e973-e979

Department of Otolaryngology, Head and Neck Surgery, University of North Carolina at Chapel Hill, North Carolina.

Objective: Characterize the speech recognition and sound source localization of patients with unilateral Menière's disease who undergo labyrinthectomy for vertigo control with simultaneous or sequential cochlear implantation.

Databases Reviewed: PubMed, Embase, and Cochrane databases.

Methods: The search was performed on May 6, 2020. Read More

Otolaryngol Head Neck Surg 2022 03 18;166(3):523-529. Epub 2021 May 18.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

Objective: The aim of this study was to evaluate the hearing outcome of cochlear implantation in patients deafened by Ménière's disease.

Study Design: Retrospective single-institution study.

Setting: Tertiary medical center. Read More

J Int Adv Otol 2021 Mar;17(2):121-126

Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara City, Nara, Japan.

Objective: To investigate otolithic function before and after endolymphatic sac drainage (ELSD) for Meniere's disease (MD) by using the subjective visual vertical test (SVV) in the upright and tilted positions.

Methods: Eighteen patients with definite unilateral MD diagnosed in accordance with the American Academy of Otolaryngology Head and Neck Surgery criteria in 1995 and Barany Society criteria in 2015 were included. SVV in the upright position and the head-tilt position was performed preoperatively and on postoperative days 1, 5, 8, 28, and 112. Read More

Auris Nasus Larynx 2021 Oct 26;48(5):803-808. Epub 2021 Mar 26.

Department of Audiology, Faculty of Health Sciences, Marmara University, Istanbul, Turkey. Electronic address:

Ménière's disease is an inner ear disease with attacks characterized by ear fullness, tinnitus, fluctuant sensorineural hearing loss and vertigo. Although pathophysiology of the disease is not fully known, endolymphatic hydrops are believed to play a role. Although there is no certain treatment procedure for Ménière's disease, some treatments are applied to prevent attacks, to treat the symptoms that occur during the attacks, and to prevent the permanent effects of the symptoms on the hearing and balance system. Read More

Eur Arch Otorhinolaryngol 2022 Mar 19;279(3):1193-1201. Epub 2021 Mar 19.

Service d'ORL et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Nantes (CHU), Hôtel-Dieu, 1, Place A. Ricordeau, BP 1005, 44093, Nantes Cedex 01, France.

Purpose: To evaluate objective vestibular function after endolymphatic sac surgery (ELSS) for Menière's disease (MD), using comparative vestibular function tests: videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP) and video head-impulse test (VHIT) METHODS: Patients with definite MD using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) of 1995 criteria modified in 2015 and treated with ELSS (sac decompression or sac opening) were included. The primary outcome was the preservation of vestibular function, comparing pre- and postoperative vestibular function tests: VNG, VEMP, VHIT. Secondary outcomes were control of episodes of vertigo, hearing outcome using AAO-HNS criteria, and QoL using the Menière's disease outcome questionnaire. Read More

Laryngoscope 2021 08 19;131(8):1845-1854. Epub 2021 Jan 19.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.

Objectives/hypothesis: Meniere's disease (MD) is a debilitating condition characterized by hearing loss, vertigo, and tinnitus. The objective of this study was to systematically investigate outcomes in MD after cochlear implantation (CoI), with and without labyrinthectomy.

Study Design: Systematic review and meta-analysis. Read More

Am J Otolaryngol 2021 Jan - Feb;42(1):102817. Epub 2020 Nov 2.

House Ear Clinic, House Institute Foundation, United States of America. Electronic address:

Meniere's disease is a peripheral audiovestibular disorder characterized by vertigo, hearing loss, tinnitus, and aural fullness. Management of these symptoms includes medical and surgical treatment. Many patients with Meniere's disease can be managed using nonablative therapy, such as intratympanic steroids and endolymphatic shunt surgery, prior to ablative techniques such as intratympanic gentamicin. Read More

Otol Neurotol 2021 01;42(1):116-120

Department of Otolaryngology, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Objective: Menière's disease can be a debilitating condition but in most cases the symptoms are controlled by lifestyle changes and medical management. However, some patients remain symptomatic despite medical treatment and have the option of more invasive surgical treatments. Surgical intervention for Menière's includes a range of interventions from grommet insertion, intratympanic steroids/Gentamicin, endolymphatic sac decompression, labyrinthectomy, and vestibular neurectomy. Read More

PLoS One 2020 30;15(10):e0240315. Epub 2020 Oct 30.

Department of Otolaryngology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

The present study was to investigate the dynamics of endolymphatic hydrops (EH) and hearing function, and explore whether the hearing loss is caused by EH alone and whether the hearing function can be modulated by changes in the EH. The extent of EH visualized by gadolinium (Gd)-enhanced inner ear magnetic resonance imaging, hearing thresholds and the summating potential/action potential ratio (-SP/AP ratio) of electrocochleography (ECochG) were recorded prior to and following surgery in 22 patients with intractable Meniere's disease (MD) who underwent endolymphatic duct blockage (EDB). The difference value of the hearing threshold and -SP/AP ratio was significantly positively correlated with the difference value of the endolymph to vestibule-volume ratio (EVVR) and grading of cochlear hydrops between prior to and following surgery. Read More

Acta Otolaryngol 2021 Jan 19;141(1):73-77. Epub 2020 Oct 19.

Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Cheeloo College of Medicine, Shandong University, Jinan, P.R. China.

Background: Three semicircular canal plugging (TSCP) is an optimized treatment for intractable Meniere's disease (MD). However, 20-30% of patients experience hearing loss after TSCP, for reasons that remain unclear.

Objective: To evaluate hearing loss resulting from TSCP. Read More

PLoS One 2020 1;15(9):e0237523. Epub 2020 Sep 1.

Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada.

Background: Meniere's disease (MD) is a chronic condition of the inner ear consisting of symptoms that include vertigo attacks, fluctuating sensorineural hearing loss, tinnitus and aural fullness. Despite availability of various interventions, there is uncertainty surrounding their relative efficacy, thus making it difficult to select the appropriate treatments for MD. The objective of this systematic review was to assess the relative effects of the available pharmacologic and surgical interventions in patients with MD with regard to vertigo and other key patient outcomes based on data from randomized clinical trials (RCTs). Read More

Otol Neurotol 2020 12;41(10):1413-1418

Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School.

Objective: To characterize presurgical symptoms and treatment history and postoperative course in patients with medically recalcitrant Menière's disease undergoing transmastoid labyrinthectomy in the post-intratympanic gentamicin era.

Study Design: Retrospective case series.

Setting: Tertiary academic medical center. Read More

JAMA Otolaryngol Head Neck Surg 2020 08;146(8):741-747

Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston.

Importance: Preservation of endolymphatic fluids, maintenance of a fluid-filled vestibule, and preservation of the cochlear nerve and its vasculature are believed to be necessary to retaining hearing after an inner-ear operation. However, some studies have reported no hearing loss despite the violation of the vestibule, questioning the importance of maintaining a fluid-filled vestibule in preserving hearing.

Objective: To report on the preservation of hearing after a complete labyrinthectomy for Meniere disease and after disruption of the vestibule. Read More

Acta Otolaryngol 2020 Oct 21;140(10):808-812. Epub 2020 Jun 21.

Ear Nose and Throat Patient Area, Trauma and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden.

Meniere's disease (MD) is a complex and multifactorial inner ear disease. The etiology of MD is unclear. Significant progress had been made in diagnosis and treatment. Read More

Transl Med UniSa 2020 May 31;22:5-9. Epub 2020 May 31.

Department of Medicine and Surgery, University of Salerno, Salerno, Italy.

Meniere's disease (MD) is an idiopathic inner ear disorder characterized by spontaneous recurrent vertigo, fluctuating sensorineural hearing loss (SNHL), aural fullness and tinnitus. Endolymphatic hydrops (EH) of the inner ear is currently considered the pathophysiological mechanisms that underlies typical symptoms of MD. MD diagnosis is based on the criteria of the Baràny Society. Read More

Sci Rep 2020 05 19;10(1):8295. Epub 2020 May 19.

Department of Surgical Sciences, Head and Neck Surgery, section of Otolaryngology, Uppsala University Hospital, Departments of Otolaryngology, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.

Meniere's disease remains enigmatic, and has no treatment with sufficient evidence. The characteristic histopathological finding is endolymphatic hydrops, suggesting either an overproduction or decreased reabsorption of endolymph in the human inner ear. This study presents the first analysis of the vascular plexus around the human endolymphatic duct using micro computed tomography and coherent synchrotron radiation with phase contrast imaging. Read More

Otolaryngol Head Neck Surg 2020 04;162(4):415-434

American Academy of Otolaryngology-Head and Neck Surgery, Alexandria, Virginia, USA.

Objective: Ménière's disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Read More

Otolaryngol Head Neck Surg 2020 04;162(2_suppl):S1-S55

American Academy of Otolaryngology-Head and Neck Surgery, Alexandria, Virginia, USA.

Objective: Ménière's disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Read More

Otol Neurotol 2020 06;41(5):669-678

Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania.

Hypothesis: Treatment modalities administered by Otolaryngologists vary based on patient volume and years of experience.

Objective: It was our goal to evaluate the current trends in treatment modalities administered by Otolaryngologists based on patient volume and years of experience.

Methods: An electronic questionnaire was distributed to all General Otolaryngologists and fellowship-trained Neurotologist members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Read More