Pub Date : 2019-12-13DOI: 10.5772/intechopen.85573
Y. Yılmaz, B. Yilmaz, A. Batıoğlu-Karaaltın
Meniere ’ s disease or syndrome is one of the most common inner ear diseases. Meniere ’ s disease is characterized by episodic vertigo, sensorineural hearing loss that fluctuates during episodes, tinnitus, and ear fullness. Ideal treatment should stop vertigo attacks, restore hearing, get rid of tinnitus and ear fullness. Treatment options are decided upon the remaining hearing, severity, and intensity of vertigo attacks. Meniere ’ s disease is progressive on hearing levels of the patient; some of them develop profound hearing loss that also could affect the other ear. In order to plan a treatment scheme for patient, these conditions should be assessed. It has a destructive and progressive nature, so the first step of treatment should contain more conservative treatment options. If symptom control could not be obtained, destructive treatment options should be considered. evoked myogenic potentials show altered tuning in patients with Ménière ’ s disease.
{"title":"Meniere’s Disease: Nonsurgical Treatment","authors":"Y. Yılmaz, B. Yilmaz, A. Batıoğlu-Karaaltın","doi":"10.5772/intechopen.85573","DOIUrl":"https://doi.org/10.5772/intechopen.85573","url":null,"abstract":"Meniere ’ s disease or syndrome is one of the most common inner ear diseases. Meniere ’ s disease is characterized by episodic vertigo, sensorineural hearing loss that fluctuates during episodes, tinnitus, and ear fullness. Ideal treatment should stop vertigo attacks, restore hearing, get rid of tinnitus and ear fullness. Treatment options are decided upon the remaining hearing, severity, and intensity of vertigo attacks. Meniere ’ s disease is progressive on hearing levels of the patient; some of them develop profound hearing loss that also could affect the other ear. In order to plan a treatment scheme for patient, these conditions should be assessed. It has a destructive and progressive nature, so the first step of treatment should contain more conservative treatment options. If symptom control could not be obtained, destructive treatment options should be considered. evoked myogenic potentials show altered tuning in patients with Ménière ’ s disease.","PeriodicalId":201520,"journal":{"name":"Meniere's Disease [Working Title]","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122220222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-23DOI: 10.5772/intechopen.84698
Carlos A. Oliveira
This chapter will discuss idiopathic Menière’s syndrome. That is to say—Menière’s disease. We will start with a brief recall on the History of Menière’s disease beginning with the description of the syndrome by Prosper Menière in 1861, the description of endolymphatic hydrops in temporal bone studies by Hallpike and Cairns in 1938 and by Yamakaua in the same year. Endolymphatic hydrops became a pathologic correlate for Menière’s syndrome. Theories that considered endolymphatic hydrops as the cause of the syndrome will be discussed. More recent studies ques-tioning the old theories and thinking of endolymphatic hydrops as an epiphenomenon in the course of the syndrome rather than the cause of the symptoms will be discussed. Temporal bone studies were the basis of these new theories too. Familial Menière’s disease will be discussed and several families will be described in detail. Because the phenotype of siblings on each family studied was variable and migraine was present in many affected members of these families a spectrum was postulated going from migraine alone to full blown Menière’s disease. Some siblings had what has been described recently as vertiginous migraine and a detailed description of this syndrome will be provided and the differences between this syndrome and Menière’s disease will be made clear. About 20% of Menière’s disease patients have a familial history. Sporadic Meniere’s disease might have a genetic predisposition and other environmental and behavioral factors contribute for the surfacing of the disease (multifactorial etiology). Because migraine is a central phenomenon and the vertiginous episodes and auditory symptoms are peripheral a hypothesis is presented for the pathophysiology of Menière’s disease. Recent research comparing vestibular migraine and Manière’s disease reinforcing the concept of these syndromes repre-senting a continuum process with similar etiology are discussed at the end.
{"title":"Menière’s Disease: Etiopathogenesis","authors":"Carlos A. Oliveira","doi":"10.5772/intechopen.84698","DOIUrl":"https://doi.org/10.5772/intechopen.84698","url":null,"abstract":"This chapter will discuss idiopathic Menière’s syndrome. That is to say—Menière’s disease. We will start with a brief recall on the History of Menière’s disease beginning with the description of the syndrome by Prosper Menière in 1861, the description of endolymphatic hydrops in temporal bone studies by Hallpike and Cairns in 1938 and by Yamakaua in the same year. Endolymphatic hydrops became a pathologic correlate for Menière’s syndrome. Theories that considered endolymphatic hydrops as the cause of the syndrome will be discussed. More recent studies ques-tioning the old theories and thinking of endolymphatic hydrops as an epiphenomenon in the course of the syndrome rather than the cause of the symptoms will be discussed. Temporal bone studies were the basis of these new theories too. Familial Menière’s disease will be discussed and several families will be described in detail. Because the phenotype of siblings on each family studied was variable and migraine was present in many affected members of these families a spectrum was postulated going from migraine alone to full blown Menière’s disease. Some siblings had what has been described recently as vertiginous migraine and a detailed description of this syndrome will be provided and the differences between this syndrome and Menière’s disease will be made clear. About 20% of Menière’s disease patients have a familial history. Sporadic Meniere’s disease might have a genetic predisposition and other environmental and behavioral factors contribute for the surfacing of the disease (multifactorial etiology). Because migraine is a central phenomenon and the vertiginous episodes and auditory symptoms are peripheral a hypothesis is presented for the pathophysiology of Menière’s disease. Recent research comparing vestibular migraine and Manière’s disease reinforcing the concept of these syndromes repre-senting a continuum process with similar etiology are discussed at the end.","PeriodicalId":201520,"journal":{"name":"Meniere's Disease [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129888914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-12DOI: 10.5772/INTECHOPEN.88014
R. Bento, P. Lopes
The aim of this chapter is to present a literature review on some of the main articles describing different interventions for the treatment in patients with pro-gressive intractable Ménière disease symptoms. Even though each paper presents good results in defending its techniques, there have been few well-designed clinical studies, that is, studies involving control groups or long-term observation, in the efficacy of surgery with respect to vertigo control and hearing preservation. Focusing on presenting the different techniques established in the literature, we dis-cuss the main indications and results obtained regarding the control of vertigo and the audiological outcomes after the procedure. Physicians should offer additional treatment strategies for Meniere’s disease patients with a long history of limiting symptoms or associated hearing loss. The surgical options for such patients should be considered carefully because surgery can damage the ipsilateral ear and the hearing function of the contralateral ear is often suboptimal. Its importance is that alternatives for treatment can only be offered to a patient when doctor knows them.
{"title":"Surgical Procedures for Ménière’s Disease","authors":"R. Bento, P. Lopes","doi":"10.5772/INTECHOPEN.88014","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88014","url":null,"abstract":"The aim of this chapter is to present a literature review on some of the main articles describing different interventions for the treatment in patients with pro-gressive intractable Ménière disease symptoms. Even though each paper presents good results in defending its techniques, there have been few well-designed clinical studies, that is, studies involving control groups or long-term observation, in the efficacy of surgery with respect to vertigo control and hearing preservation. Focusing on presenting the different techniques established in the literature, we dis-cuss the main indications and results obtained regarding the control of vertigo and the audiological outcomes after the procedure. Physicians should offer additional treatment strategies for Meniere’s disease patients with a long history of limiting symptoms or associated hearing loss. The surgical options for such patients should be considered carefully because surgery can damage the ipsilateral ear and the hearing function of the contralateral ear is often suboptimal. Its importance is that alternatives for treatment can only be offered to a patient when doctor knows them.","PeriodicalId":201520,"journal":{"name":"Meniere's Disease [Working Title]","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134189872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-10DOI: 10.5772/INTECHOPEN.86790
Y. Chai, Hongzhe Li
Ménière’s disease (MD) is an inner-ear disease mostly characterized by frequent spontaneous vertigo and fluctuating sensorineural hearing loss. The main purpose of treatment for MD is to reduce or control the vertigo while maximizing the preservation of hearing. Among the various treatments, one that is effective for refractory MD, intratympanic gentamicin (ITG), relies on its ototoxic property to effectively control the vertigo symptoms of most patients. ITG treatment has relatively few side effects compared with surgically destructive treatments, but it also carries a nonnegligible risk of sensorineural hearing loss. So far, there is no consensus on the dosage and treatment duration of ITG. Most researchers recommend that intratympanic injection of gentamicin is more suitable for patients with unilateral onset and impaired hearing function, who are younger than 65 years old, as well as with frequent and severe vertigo attacks, and ineffective prior conservative treatment. Before an ITG treatment, patients should be adequately informed about the risk of hearing loss, and in order to reduce the risk of deafness, low drug dose and long intervals between injections are recommended. In short, to administer an ITG injection, multiple factors should be comprehensively considered including patient selection, pharmacological mechanism, drug dose, the interval of administration, complications, indications, and contraindications.
{"title":"Intratympanic Gentamicin Treatment for Ménière’s Disease","authors":"Y. Chai, Hongzhe Li","doi":"10.5772/INTECHOPEN.86790","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.86790","url":null,"abstract":"Ménière’s disease (MD) is an inner-ear disease mostly characterized by frequent spontaneous vertigo and fluctuating sensorineural hearing loss. The main purpose of treatment for MD is to reduce or control the vertigo while maximizing the preservation of hearing. Among the various treatments, one that is effective for refractory MD, intratympanic gentamicin (ITG), relies on its ototoxic property to effectively control the vertigo symptoms of most patients. ITG treatment has relatively few side effects compared with surgically destructive treatments, but it also carries a nonnegligible risk of sensorineural hearing loss. So far, there is no consensus on the dosage and treatment duration of ITG. Most researchers recommend that intratympanic injection of gentamicin is more suitable for patients with unilateral onset and impaired hearing function, who are younger than 65 years old, as well as with frequent and severe vertigo attacks, and ineffective prior conservative treatment. Before an ITG treatment, patients should be adequately informed about the risk of hearing loss, and in order to reduce the risk of deafness, low drug dose and long intervals between injections are recommended. In short, to administer an ITG injection, multiple factors should be comprehensively considered including patient selection, pharmacological mechanism, drug dose, the interval of administration, complications, indications, and contraindications.","PeriodicalId":201520,"journal":{"name":"Meniere's Disease [Working Title]","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130225454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.5772/INTECHOPEN.84752
Maria Stella Arantes do Amaral, H. Pauna, A. C. Reis, M. Hyppolito
Meniere’s disease represents one of the most frequent vestibulopathy, with prevalence of 46–200 cases per 100,000, without difference between genders and manifests in fourth decade of life. Features include dizziness/vertigo, hearing loss, tinnitus, and ear fullness. Individuals with Meniere’s disease have poor quality of life due to dizziness, regarding physical, functional, and emotional aspects. The thera-peutic measures are proposed, depending on the stage of the disease. About 95% of the patients are well controlled with conservative clinical treatment. The remaining 5% have incapacitating symptoms. These patients are candidates for surgical treatments classics, decompression of the endolymphatic sac, vestibular neurectomy, or labyrinthectomy. Intratympanic gentamicin injections emerged as an alternative to surgical treatments, whose risk and benefit ratio has been shown to be much more satisfactory. Aminoglycosides, such as gentamicin have been used since the decade of 1950 for the vestibular chemical ablation in cases of intractable vertigo. The drawback is that gentamicin causes irreversible destruction to cochlear hair cells with hearing loss. The selective vestibulotoxicity in the treatment of Meniere’s disease can be used in the treatment of the vertigo promoting a chemical labyrinthectomy.
{"title":"The Treatment of Meniere’s Disease by the Intratympanic Therapy","authors":"Maria Stella Arantes do Amaral, H. Pauna, A. C. Reis, M. Hyppolito","doi":"10.5772/INTECHOPEN.84752","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84752","url":null,"abstract":"Meniere’s disease represents one of the most frequent vestibulopathy, with prevalence of 46–200 cases per 100,000, without difference between genders and manifests in fourth decade of life. Features include dizziness/vertigo, hearing loss, tinnitus, and ear fullness. Individuals with Meniere’s disease have poor quality of life due to dizziness, regarding physical, functional, and emotional aspects. The thera-peutic measures are proposed, depending on the stage of the disease. About 95% of the patients are well controlled with conservative clinical treatment. The remaining 5% have incapacitating symptoms. These patients are candidates for surgical treatments classics, decompression of the endolymphatic sac, vestibular neurectomy, or labyrinthectomy. Intratympanic gentamicin injections emerged as an alternative to surgical treatments, whose risk and benefit ratio has been shown to be much more satisfactory. Aminoglycosides, such as gentamicin have been used since the decade of 1950 for the vestibular chemical ablation in cases of intractable vertigo. The drawback is that gentamicin causes irreversible destruction to cochlear hair cells with hearing loss. The selective vestibulotoxicity in the treatment of Meniere’s disease can be used in the treatment of the vertigo promoting a chemical labyrinthectomy.","PeriodicalId":201520,"journal":{"name":"Meniere's Disease [Working Title]","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122986262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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