Meniere's disease: Pathogenesis, treatments, and emerging approaches for an idiopathic bioenvironmental disorder

Mohseni-Dargah, Masoud; Falahati, Zahra; Pastras, Christopher; Khajeh, Khosro; Mukherjee, Payal; Razmjou, Amir; Stefani, Sebastian; Asadnia, Mohsen

doi:10.1016/j.envres.2023.116972

Cited by 8 publications

(5 citation statements)

References 185 publications

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“…Although it is not clear whether EH is the cause or the concomitant phenomenon of MD, it is the main pathology change of MD ( 15 , 16 ). Electrocochleography and Gd-MRI can detect EH sensitively.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Ménière’s disease with disassociated cochlear and vestibular symptoms: a case report

Xu,

Li,

et al. 2024

Transl Pediatr

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Background Typical Ménière’s disease (MD) rarely occurs in childhood. Compared to adults, age-associated changes in vestibular function can occur during infancy and childhood. Previous case reports may have lacked some audiovestibular tests in children. It is worthwhile to follow a child with MD to observe how vertigo and hearing loss could progress under an insufficient vestibular system. Case Description A 14-year-old pediatric patient with disassociated episodes between vertigo and hearing loss was finally diagnosed with MD. He was diagnosed with probable MD due to lack of objective evidence of hearing loss in his first two admissions. However, in his third admission, he had hearing loss even without attack of vertigo and was finally diagnosed. By listing the patient’s audiovestibular auxiliary tests in a chronological order, we might follow the progress of pediatric MD. Gadolinium-enhanced magnetic resonance imaging (Gd-MRI) might be sensitive to reflect endolymphatic hydrops (EH). Medications including corticosteroids might be effective for both hearing loss and vertigo. Conclusions In pediatric MD, vestibular and cochlear symptoms may occur and progress independently. Audiovestibular evaluation, especially caloric tests and cervical vestibular evoked myogenic potential (cVEMP), can be useful for pediatric MD. Gd-MRI can be sensitive for detecting EH. Both systemic and postauricular administration of corticosteroids might be effective in alleviating vertigo and improving hearing. Prolongation of the follow-up period of pediatric MD is warranted.

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Section: Discussionmentioning

confidence: 99%

Pediatric Ménière’s disease with disassociated cochlear and vestibular symptoms: a case report

Xu,

Li,

et al. 2024

Transl Pediatr

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“…Although there may be multiple causes of MD, if a cause is defined, such as head trauma or a genetic cause or migraines, then the symptoms are defined as Meniere’s syndrome, and treatment of the primary cause is recommended [ 23 , 24 ]. Treatment of MD usually starts with a conservative approach.…”

Section: Discussionmentioning

confidence: 99%

“…Rather, the authors suggest that EH is a manifestation of labyrinthine homeostasis that can result in MD and can be caused by many different processes (Figure 1) [20,22]. Although there may be multiple causes of MD, if a cause is defined, such as head trauma or a genetic cause or migraines, then the symptoms are defined as Meniere's syndrome, and treatment of the primary cause is recommended [23,24]. Treatment of MD usually starts with a conservative approach.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Response of Meniere’s Disease Utilizing Sorbus domestica

Williams

2024

Cureus

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Introduction Meniere’s disease (MD) is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, and tinnitus. MD can impart a significant socioeconomic impact with associated progressive hearing loss. First-line therapies consist of diuretics and antihistamines, with second-line therapies including intratympanic steroids and pulse therapy. Third-line treatments include endolymphatic sac surgery (ELSS) followed by intratympanic gentamicin injection and/or vestibular neurectomy. The gemmotherapy Sorbus domestica's inherent properties to regulate venous circulation and lymphatic drainage have been utilized in the European literature for the treatment of MD and the patients in this study. Methods Patients presenting for rehabilitation at Pulaski Health and Rehabilitation Facility with a history of vertigo were examined and, through history and specific exam, to define MD. This resulted in six patients whose symptoms and exam were consistent with MD and interfered with their therapeutic progression. These patients were offered and accepted treatment with Sorbus domestica for their MD. Results All patients responded with either resolution or significant improvement in their symptoms and hearing loss. Treatment also resulted in an improved and probably shortened rehabilitative course. All patients had no adverse reactions and were supplied with resources for continual treatment upon discharge. Conclusion Sorbus domestica is a safe and viable treatment option for MD. It has been useful, especially in treatment-resistant diseases, without side effects and can be utilized in initial cases with improvement or resolution of hearing loss.

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“…To date there is no cure for Ménière's Disease. An excellent recent review describes in detail the various treatment options ranging from conservative to destructive that are currently used by five different international Ménière's Disease guidelines (Mohseni-Dargah et al, 2023). In all instances, at the end stage of disease, the last remaining treatment option requires either the removal of the peripheral vestibular organs or resection of the vestibular portion of the vestibulocochlear nerve.…”

Section: Introductionmentioning

confidence: 99%

Anatomical and functional studies of isolated vestibular neuroepithelia from Ménière’s Disease patients

Drury,

Tadros,

Callister

et al. 2024

Preprint

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Surgical removal of vestibular end organs is a final treatment option for people with intractable Meniere's Disease. We describe the use of surgically excised vestibular neuroepithelium from patients with Meniere's Disease for 1) anatomical investigation of hair cell and nerve fibres markers using immunohistochemistry and 2) functional studies using electrophysiological recordings of voltage-activated currents. Our data shows considerable reduction in and disorganization of vestibular hair cells in the cristae ampullares while nerve fibres are in contact with remaining sensory receptors but appear thin in regions where hair cells are absent. Electrophysiological recordings of voltage-activated potassium currents from surviving hair cells demonstrate normal activity in both type I and type II vestibular hair cells. In addition, current-voltage plots from type I vestibular hair cells are consistent with the presence of a surrounding calyx afferent terminal. These data indicate surviving hair cells in Meniere's Disease patients remain functional and capable of transmitting sensory information to the central nervous system. Determining functionality of vestibular receptors and nerves is critical for vestibular implant research to restore balance in people with Meniere's Disease.

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Meniere's disease: Pathogenesis, treatments, and emerging approaches for an idiopathic bioenvironmental disorder

Cited by 8 publications

References 185 publications

Pediatric Ménière’s disease with disassociated cochlear and vestibular symptoms: a case report

Pediatric Ménière’s disease with disassociated cochlear and vestibular symptoms: a case report

Therapeutic Response of Meniere’s Disease Utilizing Sorbus domestica

Anatomical and functional studies of isolated vestibular neuroepithelia from Ménière’s Disease patients

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