Update on the pathophysiology, diagnosis and management of Ménière's disease.

IF 1.9 4区 医学 Q2 OTORHINOLARYNGOLOGY Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2024-10-01 Epub Date: 2024-07-22 DOI:10.1097/MOO.0000000000001002
Jose A Lopez-Escamez, Patricia Perez-Carpena
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Abstract

Purpose of review: The aim of this work is to summarize the main advances on the pathophysiology, diagnosis, and treatment of Meniere's disease (MD).

Recent findings: Different immune responses to biotic stimuli may trigger MD, with subgroups identified based on cytokine and genetic profile, suggesting potential benefits from immune therapy, including antiallergic medication. Genetic and epigenetic research, along with imaging studies, reveal the complexity of MD, involving inflammation, immunity, and metabolic processes. Advanced imaging techniques define specific temporal bone features and endolymphatic hydrops, while machine learning models enhance diagnostic accuracy through clinical and laboratory data analysis. Differentiating MD from vestibular migraine remains challenging due to overlapping symptoms, but combining vestibular tests, audiological assessments, and biomarkers like cytokines and chemokines shows promise. Pharmacological treatments such as betahistine or corticosteroids show varying effectiveness and require further research according to immune subgroups. Surgical options like endolymphatic sac decompression, semicircular canal occlusion and labyrinthectomy are restricted to intractable cases.

Summary: Research into MD aims to improve diagnosis and treatment through genetic, immunological, and advanced imaging studies. Current treatments include pharmacological, intratympanic, and surgical interventions, but current research supports a personalized approach based on clinical and molecular re-definition of patient subgroups.

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梅尼埃病的最新病理生理学、诊断和治疗方法。
综述的目的:本文旨在总结梅尼埃病(MD)的病理生理学、诊断和治疗方面的主要进展:对生物刺激的不同免疫反应可能引发美尼尔氏病,根据细胞因子和遗传特征确定了亚组,这表明免疫疗法(包括抗过敏药物)可能带来益处。遗传学和表观遗传学研究以及成像研究揭示了 MD 的复杂性,其中涉及炎症、免疫和代谢过程。先进的成像技术确定了特定的颞骨特征和内淋巴水肿,而机器学习模型则通过临床和实验室数据分析提高了诊断的准确性。由于症状重叠,将 MD 与前庭性偏头痛区分开来仍具有挑战性,但将前庭测试、听力评估以及细胞因子和趋化因子等生物标志物结合起来则大有可为。药物治疗(如倍他司汀或皮质类固醇)显示出不同的效果,需要根据免疫亚群进行进一步研究。内淋巴囊减压术、半规管闭塞术和迷走神经切除术等手术治疗方法仅限于难治性病例:MD 的研究旨在通过遗传学、免疫学和先进的成像研究来改进诊断和治疗。目前的治疗方法包括药物、鼓膜内注射和手术干预,但目前的研究支持基于临床和分子重新定义患者亚群的个性化方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
96
审稿时长
6-12 weeks
期刊介绍: Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.
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