Clinical Indicators Useful in Predicting Response to the Medical Management of Meniere's Disease

Devaiah, Anand K.; Ator, Gregory A.

doi:10.1097/00005537-200011000-00018

Cited by 19 publications

(16 citation statements)

References 14 publications

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“…17,18 Because Ménière disease is an inner ear disease that is not systemic, urinary samples were collected as controls from outpatients with Ménière disease and normal renal function. Between December 2007 and December 2008, we recruited 16 patients who were diagnosed at Kagawa University Medical School with Ménière disease based on the clinical course and diagnostic categories according to the 1995 guidelines from the American Academy of Otolaryngology-Head and Neck Surgery Committee of Hearing and Equilibrium.…”

Section: Methodsmentioning

confidence: 99%

Relationship Between Urinary Angiotensinogen and Salt Sensitivity of Blood Pressure in Patients With IgA Nephropathy

et al. 2011

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We demonstrated previously that the blood pressure of patients with IgA nephropathy becomes salt sensitive as renal damage progresses. We also showed that increased urinary angiotensinogen levels in such patients closely correlate with augmented renal tissue angiotensinogen gene expression and angiotensin II levels. Here, we investigated the relationship between urinary angiotensinogen and salt sensitivity of blood pressure in patients with IgA nephropathy. Forty-one patients with IgA nephropathy consumed an ordinary salt diet (12 g/d of NaCl) for 1 week and a low-salt diet (5 g/d of NaCl) for 1 week in random order. The salt-sensitivity index was calculated as the reciprocal of the slope of the pressure-natriuresis curve drawn by linking 2 data points obtained during consumption of each diet. The urinary angiotensinogen:creatinine ratio was significantly higher in patients who consumed the ordinary salt diet compared with the low-salt diet (17.5 μg/g [range: 7.3 to 35.6 μg/g] versus 7.9 μg/g [range: 3.1 to 14.2 μg/g] of creatinine, respectively; P<0.001). The sodium sensitivity index in our patients positively correlated with the glomerulosclerosis score (r=0.43; P=0.008) and changes in logarithmic urinary angiotensinogen:creatinine ratio (r=0.37; P=0.017) but not with changes in urinary protein excretion (r=0.18; P=0.49). In contrast, changes in sodium intake did not alter the urinary angiotensinogen:creatinine ratio in patients with Ménière disease and normal renal function (n=9). These data suggest that the inappropriate augmentation of intrarenal angiotensinogen induced by salt and associated renal damage contribute to the development of salt-sensitive hypertension in patients with IgA nephropathy.

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Section: Methodsmentioning

confidence: 99%

Relationship Between Urinary Angiotensinogen and Salt Sensitivity of Blood Pressure in Patients With IgA Nephropathy

et al. 2011

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“…During episodes of fluctuating sensorineural hearing loss, patients may be prescribed oral steroids, intratympanic (IT) steroids, or a combination of both. 15 Certain patients may elect to undergo endolymphatic sac surgery as a hearing preservation procedure to release pressure in the endolymphatic sac to control intractable symptoms. All patients within this study received maximal medical therapy before considering surgical labyrinthectomy as an option.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Developing Contralateral Ménière’s Disease in Patients Undergoing Transmastoid Labyrinthectomy for Unilateral Ménière’s Disease

et al. 2019

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Objectives: To analyze the incidence of developing contralateral Ménière's disease (MD) in patients who undergo labyrinthectomy for vestibular dysfunction in unilateral MD. Study Design: Retrospective chart review. Participants and Methods: Adult patients with a diagnosis of MD who underwent surgical labyrinthectomy with minimum follow-up of 12 months were included. Patients who experienced chemical labyrinthectomy, surgical labyrinthectomy for a diagnosis other than MD, contralateral ear surgery, or bilateral MD before the labyrinthectomy were excluded. The key outcome measure is whether symptoms of MD developed in the contralateral ear post-labyrinthectomy. Statistical analysis was performed using w 2 (Fisher exact) test for discrete variables and the Student t test for continuous variables. A P value < .05 was considered significant. Results: Of the140 patients who underwent labyrinthectomy for intractable vertigo due to unilateral MD, 84 had at least 1 year follow-up appointments. Twelve percent (10/84) of these patients developed contralateral MD, which was diagnosed by a neuro-otologist based on symptoms consistent with MD, including low-frequency sensorineural hearing loss. Average age in years is 63.12 (10.83; mean [SD]) at time of surgery. Average follow-up was 35.57 (15.89) months (range: 12-69 months). Conclusion: The incidence of contralateral MD development in patients who underwent labyrinthectomy for unilateral MD is 12%. The current literature states that MD has a 30% bilateral involvement rate. Our incidence is significantly lower when compared to the current literature.

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“…1 Some explanations for the variation in sensitivity include patient hearing levels, method of stimulation, cutoff for positive interpretation, ECochG characteristic measured, and location of electrode; in general, a sensitivity around 60% is a consistent expectation. 1,[8][9][10][11][12][13] Medical intervention in the early stages of MD can help preserve inner ear function, 2,6 and therefore it is important to identify these patients with possible MD. This particular subpopulation of MD patients has the best chance for functional preservation with intervention, but unfortunately possible MD has an enigmatic presentation.…”

Section: Commentmentioning

confidence: 99%

“…It is these patients who can particularly benefit from early detection and intervention to prevent further deterioration of inner ear function. 6 The use of SP/AP area ratios in improving diagnostic sensitivity for this particular subset of patients with MD has not been explored, and is the subject of this study.…”

mentioning

confidence: 99%

Utility of Area Curve Ratio Electrocochleography in Early Meniere Disease

Devaiah¹,

Dawson²,

Ferraro³

et al. 2003

Arch Otolaryngol Head Neck Surg

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Clinical Indicators Useful in Predicting Response to the Medical Management of Meniere's Disease

Cited by 19 publications

References 14 publications

Relationship Between Urinary Angiotensinogen and Salt Sensitivity of Blood Pressure in Patients With IgA Nephropathy

Relationship Between Urinary Angiotensinogen and Salt Sensitivity of Blood Pressure in Patients With IgA Nephropathy

Incidence of Developing Contralateral Ménière’s Disease in Patients Undergoing Transmastoid Labyrinthectomy for Unilateral Ménière’s Disease

Utility of Area Curve Ratio Electrocochleography in Early Meniere Disease

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