Treatment of Menière’s Disease

Sharon, Jeffrey D.; Treviño, Carolina; Schubert, Michael C.; Carey, John P.

doi:10.1007/s11940-015-0341-x

Cited by 49 publications

(50 citation statements)

References 67 publications

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“…A primary treatment widely recommended is the reduction of salt intake and the use of diuretics to lower the volume and pressure of endolymph [78,81]. Second, one of the most prescribed regular treatments in Europe is the use of betahistine [58,81].…”

Section: Current Treatment Optionsmentioning

confidence: 99%

“…Second, one of the most prescribed regular treatments in Europe is the use of betahistine [58,81]. Next to betahistine, cinnarizine is also prescribed, particularly in the Netherlands [58].…”

Section: Current Treatment Optionsmentioning

confidence: 99%

“…A more invasive treatment shown to be effective in a large number of Ménière's patients, involves intratympanic steroids [53] and gentamicin injections, the latter functionally destroying the vestibular end organ [69,78,81]. Another invasive treatment involves surgery of the labyrinth, such as endolymphatic sac surgery, vestibular nerve section and labyrinthectomy [78,81]. In addition to these treatments, many patients use hearing aids to compensate for their hearing loss and/or tinnitus [58,81].…”

Section: Current Treatment Optionsmentioning

confidence: 99%

“…Another invasive treatment involves surgery of the labyrinth, such as endolymphatic sac surgery, vestibular nerve section and labyrinthectomy [78,81]. In addition to these treatments, many patients use hearing aids to compensate for their hearing loss and/or tinnitus [58,81].…”

Section: Current Treatment Optionsmentioning

confidence: 99%

“…Moreover, despite the fact that MD has been judged idiopathic, and the hydrops has not been confirmed to be a necessary and sufficient condition for the disease [30], there is little doubt as to its vestibular cause [6,40,54,81]. In particular, it has been shown that MD is characterised by vestibular hypofunction [56,57,65,71,80].…”

Section: The Star-walk Induced By a Drifting After-imagementioning

confidence: 99%

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Treatment of vestibular disorders with weak asymmetric base-in prisms: An hypothesis with a focus on Ménière’s disease

Bos

Lubeck

Vente³

2018

VES

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Abstract.BACKGROUND: Regular treatments of Ménière's disease (MD) vary largely, and no single satisfactory treatment exists. A complementary treatment popular among Dutch and Belgian patients involves eyeglasses with weak asymmetric base-in prisms, with a perceived high success rate. An explanatory mechanism is, however, lacking. OBJECTIVE: To speculate on a working mechanism explaining an effectiveness of weak asymmetric base-in prims in MD, based on available knowledge. METHODS: After describing the way these prisms are prescribed using a walking test and its effect reported on, we give an explanation of its underlying mechanism, based on the literature. RESULTS: The presumed effect can be explained by considering the typical star-like walking pattern in MD, induced by a drifting after-image comparable to the oculogyral illusion. Weak asymmetric base-in prisms can furthermore eliminate the conflict between a net vestibular angular velocity bias in the efferent signal controlling the VOR, and a net re-afferent ocular signal. CONCLUSIONS: The positive findings with these glasses reported on, the fact that the treatment itself is simple, low-cost, and socially acceptable, and the fact that an explanation is at hand, speak in favour of elaborating further on this treatment.

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Section: Current Treatment Optionsmentioning

confidence: 99%

Section: Current Treatment Optionsmentioning

confidence: 99%

Section: Current Treatment Optionsmentioning

confidence: 99%

Section: Current Treatment Optionsmentioning

confidence: 99%

Section: The Star-walk Induced By a Drifting After-imagementioning

confidence: 99%

See 3 more Smart Citations

Treatment of vestibular disorders with weak asymmetric base-in prisms: An hypothesis with a focus on Ménière’s disease

Bos

Lubeck

Vente³

2018

VES

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Lifestyle and dietary interventions for Ménière’s disease

Webster

Harrington-Benton²,

Judd

et al. 2022

Cochrane Database of Systematic Reviews

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Cochrane Database of Systematic Reviews and 7) other adverse e ects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We used GRADE to assess the certainty of evidence for each outcome. Main resultsWe included two RCTs, one related to diet, and the other related to fluid intake and sleep. In a Swedish study, 51 participants were randomised to receive 'specially processed cereals' or standard cereals. The specially processed cereals are thought to stimulate the production of anti-secretory factor -a protein that reduces inflammation and fluid secretion. Participants received the cereals for three months. The only outcome reported by this study was disease-specific health-related quality of life.The second study was conducted in Japan. The participants (223) were randomised to receive abundant water intake (35 mL/kg/day), or to sleep in darkness (in an unlit room for six to seven hours per night), or to receive no intervention. The duration of follow-up was two years. The outcomes assessed were 'improvement in vertigo' and hearing.As these studies considered di erent interventions we were unable to carry out any meta-analysis, and for almost all outcomes the certainty of the evidence was very low. We are unable to draw meaningful conclusions from the numerical results. Authors' conclusionsThe evidence for lifestyle or dietary interventions for Ménière's disease is very uncertain. We did not identify any placebo-controlled RCTs for interventions that are frequently recommended for those with Ménière's disease, such as salt restriction or ca eine restriction. We identified only two RCTs that compared a lifestyle or dietary intervention to placebo or no treatment, and the evidence that is currently available from these studies is of low or very low certainty. This means that we have very low confidence that the e ects reported are accurate estimates of the true e ect of these interventions. Consensus on the appropriate outcomes to measure in studies of Ménière's disease is needed (i.e. a core outcome set) in order to guide future studies in this area and enable meta-analyses of the results. This must include appropriate consideration of the potential harms of treatment, as well as the benefits.

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Lifestyle and dietary interventions for Ménière’s disease

Webster

George

Lee

et al. 2023

Cochrane Database of Systematic Reviews

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Background Ménière's disease is a condition that causes recurrent episodes of vertigo, associated with hearing loss and tinnitus. Lifestyle or dietary modifications (including reducing the amount of salt or caffeine in the diet) are sometimes suggested to be of benefit for this condition. The underlying cause of Ménière's disease is unknown, as is the way in which these interventions may work. The efficacy of these different interventions at preventing vertigo attacks, and their associated symptoms, is currently unclear. Objectives To evaluate the benefits and harms of lifestyle and dietary interventions versus placebo or no treatment in people with Ménière's disease. Search methods The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 14 September 2022. Selection criteria We included randomised controlled trials (RCTs) and quasi‐RCTs in adults with Ménière's disease comparing any lifestyle or dietary intervention with either placebo or no treatment. We excluded studies with follow‐up of less than three months, or with a cross‐over design (unless data from the first phase of the study could be identified). Data collection and analysis We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vertigo (assessed as a dichotomous outcome ‐ improved or not improved), 2) change in vertigo (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease‐specific health‐related quality of life, 5) change in hearing, 6) change in tinnitus and 7) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We used GRADE to assess the certainty of evidence for each outcome. Main results We included two RCTs, one related to diet, and the other related to fluid intake and sleep. In a Swedish study, 51 participants were randomised to receive 'specially processed cereals' or standard cereals. The specially processed cereals are thought to stimulate the production of anti‐secretory factor ‐ a protein that reduces inflammation and fluid secretion. Participants received the cereals for three months. The only outcome reported by this study was disease‐specific health‐related quality of life. The second study was conducted in Japan. The participants (223) were randomised to receive abundant water intake (35 mL/kg/day), or to sleep in darkness (in an unlit room for six to seven hours per night), or to receive no intervention. The duration of follow‐up was two years. The outcomes assessed were 'improvement in vertigo' and hearing. As these studie...

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Treatment of Menière’s Disease

Cited by 49 publications

References 67 publications

Treatment of vestibular disorders with weak asymmetric base-in prisms: An hypothesis with a focus on Ménière’s disease

Treatment of vestibular disorders with weak asymmetric base-in prisms: An hypothesis with a focus on Ménière’s disease

Lifestyle and dietary interventions for Ménière’s disease

Lifestyle and dietary interventions for Ménière’s disease

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