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Auris Nasus Larynx 2021 Mar 24. Epub 2021 Mar 24.

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

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

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

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

Acta Otolaryngol 2020 Apr 7;140(4):258-261. Epub 2020 Feb 7.

Department of Otolaryngology, Head & Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Endolymphatic sac decompression surgery (ESDS) is commonly used for intractable Meniere's disease, but its effect remains controversial because of the low rate of vertigo control. In the present study, we examined ESDS combined with posterior tympanotomy with local steroids as a new therapeutic strategy for intractable Meniere's disease. This retrospective study enrolled 19 patients with Meniere's disease using ESDS combined with posterior tympanotomy with local steroids between 2015 and 2018. Read More

Orv Hetil 2020 Feb;161(5):177-182

Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika,Semmelweis Egyetem, Általános Orvostudományi KarBudapest, Szigony u 36., 1083.

Tenotomy of the tendon of the stapedius and tensor tympani (TT) muscles is a minimal-invasive surgical therapeutic procedure in Ménière's disease (MD). It has been assumed that the TT medializes the stapes into the oval window, resulting in changes in perilymphatic pressures of the inner ear. By cutting the tendons of both middle ear muscles, they affect the pressure dynamics by not augmenting this pressure even further. Read More

Eur Arch Otorhinolaryngol 2020 Jun 7;277(6):1847-1848. Epub 2020 Jan 7.

Surgical Sciences Department, University of Turin, Turin, Italy.

In this letter, we discuss possible alternatives and future perspectives in the therapy of Meniere's disease. Special attention should be paid to the role of dietary restrictions for glucose in patients with Meniere's disease, as there is a strong evidence about the presence of insulin receptors in the saccule, the main structure affected by pathological changes due to endolymphatic hydrops; to the possible use of endogenous antisecretory factor administered in specially processed cereals; and to the effects of low-dose intratympanic gentamicin, especially in patients with intractable Meniere's disease. Read More

Syst Rev 2019 12 30;8(1):341. Epub 2019 Dec 30.

Center for Practice Changing Research, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8 L6, Canada.

Background: Hearing loss is one of the leading causes of disability in Canada and worldwide, with more than one million Canadians enduring a hearing-related disability. Meniere's disease (MD) is a chronic condition of the inner ear, manifesting as a triad of disabling symptoms, including attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), and tinnitus. Impacts on quality of life are severe, particularly with respect to restrictions in social participation and physical activity, fatigue, and reduced capacity to work. Read More

Sci Rep 2019 12 18;9(1):19397. Epub 2019 Dec 18.

Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, 250022, P.R. China.

This study aims to investigate the causes of vertigo relapse in patients with Meniere's disease (MD) who had undergone triple semicircular canal plugging (TSCP) and explore the morphologic changes of vestibular organ through revision surgery. Eleven intractable MD patients who underwent TSCP initially and experienced episodic vertigo recurrence later, were enrolled. All patients accepted revision surgery, including seven cases who underwent labyrinthectomy and four cases who underwent repeat TSCP. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2020 Jan 9;137(1):47-51. Epub 2019 Dec 9.

University of Grenoble Alpes, IRMaGe, 38000 Grenoble, France; Department of Neuroradiology, Lariboisière University Hospital, 75010 Paris, France.

Endolymphatic hydrops features excess endolymph in the membranous labyrinth, and is a marker of Menière's disease. Between the early 1980s and late 2000s, MRI in Menière's disease aimed purely to rule out tumor or malformation as differential diagnoses for the pressure disorder. Progress in high-resolution MRI, however, now enables excess endolymph to be visualized in the membranous labyrinth, differentiating saccule and utricle in Menière's disease and in other clinical presentations such as cochleovestibular schwannoma. Read More

Laryngoscope 2020 08 11;130(8):2040-2046. Epub 2019 Nov 11.

Department of Sense Organs and Ear, Nose, and Throat Department, Sapienza University of Rome, Rome, Italy.

Objectives/hypothesis: To evaluate the incidence of chronic cerebrospinal venous insufficiency in Menière's disease patients and the effect of bilateral percutaneous transluminal angioplasty of the jugular/azygos veins compared to medical therapy.

Study Design: Prospective case-control study.

Methods: Five hundred fourteen subjects were included in the study, 412 affected by definite Menière's disease, and 102 healthy controls. Read More

Eur Arch Otorhinolaryngol 2020 Feb 31;277(2):367-375. Epub 2019 Oct 31.

University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.

Purpose: To evaluate the insertion results and hearing preservation of a novel slim modiolar electrode (SME) in patients with residual hearing.

Methods: We retrospectively collected the data from the medical files of 17 patients (18 ears) implanted with a SME. All patients had functional low frequency hearing (PTA  ≤ 80 dB HL). Read More

J Vestib Res 2019 ;29(6):315-322

Department of Otorhinolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, P.R. China.

Introduction: Meniere's disease is a common chronic inner ear disease. Because the definitive pathogenesis is still unknown, there is currently no cure for this disorder. Semicircular canal plugging (SCP), first used to treat patients with intractable benign paroxysmal positional vertigo, has since been applied to patients with intractable peripheral vertigo. Read More

Med Hypotheses 2020 Jan 12;134:109430. Epub 2019 Oct 12.

Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, USA; Department of Biomedical Engineering, University of California, Irvine, USA. Electronic address:

Meniere's disease (MD) is a chronic condition affecting the inner ear whose precise etiology is currently unknown. We propose the hypothesis that MD is a migraine-related phenomenon which may have implications for future treatment options for both diseases. The association between MD and migraine is both an epidemiological and a mechanistic one, with up to 51% of individuals with MD experiencing migraine compared to 12% in the general population. Read More

Braz J Otorhinolaryngol 2019 Nov - Dec;85(6):788-798. Epub 2019 Sep 20.

Universidade de Brasília (UnB), Faculdade de Ciências de Saúde, Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil; Faculdade de Ciências de Saúde ‒ Asa Norte, Brasília, DF, Brazil; Hospital Universitário de Brasília, Brasília, DF, Brazil. Electronic address:

Introduction: People with vestibular loss present a deficit in the vestibular system, which is primarily responsible for promoting postural control, gaze stabilization, and spatial orientation while the head moves. There is no effective treatment for a bilateral loss of vestibular function. Recently, a vestibular implant was developed for people with bilateral loss of vestibular function to improve this function and, consequently, the quality of life of these patients. Read More

Acta Otolaryngol 2019 Dec 26;139(12):1053-1057. Epub 2019 Sep 26.

Department of Health Care, Beijing Hospital, National Center of Gerontology, Beijing, PR China.

Meniere's disease appears to be a complex inner ear disorder and also remains a controversial and often difficult disease as regards determination of diagnosis, pathogenesis and especially optimal treatment. To investigate the long-term effects of progressive surgical treatment in the management of the vertigo attacks of intractable Meniere's disease. Eighteen patients with medically intractable and active Meniere's disease were opted to try Meniett pulse generator (Meniett), endolymphatic sac decompression (ESD) and triple semicircular canal occlusion (TSCO) in order to control the attacks of vertigo. Read More

Otol Neurotol 2019 10;40(9):1208-1216

Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Hypothesis: Objective physiologic changes measured using electrocochleography at the round window (ECOG) are observable during endolymphatic sac decompression and shunt surgery (ELS).

Background: Limited effective treatment options are available to patients with Menière's disease (MD) who have failed conservative management, experience persistent vertigo symptoms, and have substantial residual hearing. ELS is a feasible therapeutic option for these patients. Read More

Clin Neurophysiol 2019 09 31;130(9):1539-1556. Epub 2019 May 31.

Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland.

Cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs respectively) are now used by an increasing number of laboratories to evaluate otolith inner ear function and their pathways through the central nervous system. However, the literature is incomplete or unclear as to what information both c- and oVEMPs can add beyond what a good clinical examination can provide, and what other paramedical tests can provide also, and the present review aims to clarify what is known so far. The following review will describe what is known with regards to both c- and oVEMPs and their use. Read More

Acta Otolaryngol 2019 Sep 5;139(9):739-746. Epub 2019 Jul 5.

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

Endolymphatic sac drainage (ELSD) may have a positive effect on endolymphatic hydrops (EH) and may help to preserve inner ear function. However, the relationship between changes in EH volumes and hearing function after ELSD has not been described. We aimed to reveal the factors related to changes in hearing and EH following ELSD. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019 Jun;33(6):501-504

Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

To compare functional outcomes after different surgical procedures in treatment of patients with Meniere's disease. Patients with Meniere's disease were categorized into different groups mainly based on pure-tone average and functional level scale. Individualized surgical procedure was provided including endolymphatic sac shunt or decompression (ELSS), vestibular neurectomy (VN), labyrinthectomy (LC), semicircular canals plugging (SCP) and endolymphatic duct blockage (EDB). Read More

J Int Adv Otol 2019 Apr;15(1):121-129

Department of Neurology, Hubei University of Medicine, Taihe Hospital, Shiyan, China.

Objectives: This study aimed to assess the clinical benefit of device therapy on controlling the symptoms of Meniere's disease (MD).

Materials And Methods: We searched PubMed, Embase, the Cochrane Library, China National Knowledge Internet, and Wanfang Data before January 13, 2018. We selected randomized controlled clinical trials, case-controlled studies, and cohort studies that dealt with outcomes of device therapy for the treatment of MD. Read More

Eur Arch Otorhinolaryngol 2019 Jul 11;276(7):1943-1950. Epub 2019 Apr 11.

UOSD "Vestibologia E Otorinolaringoiatria" Presidio Ospedaliero "Giovanni Paolo II", Policoro, Italy.

Purpose: Ménière's disease (MD) is an inner ear disorder of unknown etiology, whose pathological substrate is the endolymphatic hydrops. Different treatments have been proposed; however, evidence of their effectiveness is lacking. The aim of this study was to evaluate by a questionnaire which medical and surgical treatments are used in Italy for the treatment of MD and to compare them with those proposed in other countries. Read More