This study attempted to determine the prevalence of migraine in unilateral classic Menière's disease and vestibular Menière's disease. Diagnostic criteria for these three entities were identified and charts of patients with episodic vertigo were reviewed. A questionnaire was designed to assess the prevalence of migraine using criteria established previously by other authors. Questionnaires were mailed to patients with classic Menière's disease, patients with vestibular Menière's disease, and a normal control group. The response rates from the questionnaires in the three groups were 75%, 70%, and 36%. The percentages of the respondents who met the predetermined criteria for migraine in the three groups were 22%, 81%, and 33%. The significant difference in migraine prevalence between classic and vestibular Menière's disease suggests the possibility of different etiologies for the two entities.
Multiple-canal BPPV was rare, and usually involved canals on the same side; simultaneous involvement of the posterior and lateral canals was much more common than involvement of the anterior and posterior canals or the anterior and lateral canals. Trauma increased the risk for multiple-canal BPPV, but not the risk for bilateral single-canal BPPV. Cupulolithiasis was not a factor in multiple-canal BPPV.
The middle cranial fossa surgical approach has been used for the removal of acoustic neuromas in 43 patients at the University of Iowa since 1974. Hearing was maintained in 50% of patients with tumors 1.5 cm or less outside the porus acusticus. Postoperative hearing, facial nerve function, and complications were similar to reports using the suboccipital or retrosigmoid approach to preserve hearing for this size tumor. The character of the tumor appears to dictate the postoperative outcome rather than the surgical approach.
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