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Therapeutic Options in Meniere's Disease

Therapeutic Options in Meniere's Disease Abstract • Emphasis on treatment in Meniere's disease has recently shifted from a concentration on the vertiginous component alone to include conservation or improvement of hearing as well. This presentation tabulates the current otological literature's reports of both the medical and surgical options available in the treatment of Meniere's disease. The authors conclude that these more recent reports deemphasize the importance of the vertiginous component, while emphasizing the importance of the hearing component in evaluation of the efficacy of any therapeutic modality. Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. In nonreversible or nonfluctuating hearing deficits with hearing worth conserving, vestibular neurectomy with excision of Scarpa's ganglion yields the best results. (Arch Otolaryngol 103:589-593, 1977) References 1. Hallpike CS, Cairns H: Observations on the pathology of Meniere's syndrome . Proc R Soc Med 31:1317-1336, 1938. 2. Furstenberg AC, Lashmet FH, Lathrop FD: Meniere's symptom complex: Medical treatment . Ann Otol Rhinol Laryngol 43:1035-1047, 1934. 3. Furstenberg AC, Richardson G, Lathrop FD: Meniere's disease: Addenda to medical therapy . Arch Otolaryngol 34:1083-1092, 1941.Crossref 4. Perlman HP, Goldinger JM, Cales JO: Electrolyte studies in Meniere's disease . Laryngoscope 63:640-651, 1953.Crossref 5. Suga F, Snow JB Jr: Cochlear blood flow in response to vasodilating drugs and some related agents . Laryngoscope 79:1956-1979, 1969.Crossref 6. Wilson WH: Intravenous and optimum-dosage histamine therapy in Meniere's disease . Arch Otolaryngol 97:139-141, 1973.Crossref 7. Caparosa RJ: Medical treatment for Meniere's disease . Laryngoscope 73:666-672, 1963.Crossref 8. Elia JC: Double-blind evaluation of a new treatment for Meniere's syndrome . JAMA 196:187-189, 1966.Crossref 9. Bertrand RA: Meniere's disease: Subjective and objective evaluation of medical treatment with betahistine hydrochloride . Acta Otolaryngol Suppl 305:48-69, 1972.Crossref 10. Hicks JJ, Hicks JN, Cooley HN: Meniere's disease . Arch Otolaryngol 86:610-613, 1967.Crossref 11. Wolfson RJ, Myers D, Schlosser WD: Meniere's disease: Treatment with betahistine hydrochloride . Eye Ear Nose Throat Monthly 46:891-896, 1967. 12. Hommes OR: A study of the efficacy of betahistine in Meniere's syndrome . Acta Otolaryngol Suppl 305:70-79, 1972.Crossref 13. Shea JJ, Bowers RE: Diagnosis and treatment of fluctuant hearing loss . Otolaryngol Clin North Am 8:431-438, 1975. 14. Jongkees LBW: Medical treatment of Meniere's disease . Acta Otolaryngol Suppl 192:109-112, 1963. 15. Futaki T, Kitahara M, Morimoto M: Meniere's disease and diphenidol: A critical analysis of symptoms and equilibrium function tests . Acta Otolaryngol Suppl 330:120-128, 1975.Crossref 16. Marlow FI: Drug treatment of Meniere's disease . Otolaryngol Clin North Am 6:119-129, 1973. 17. Boedts DA, Vandenhove PT: Droperidolfentanyl citrate in equilibratory disturbances . Arch Otolaryngol 89:715-719, 1969.Crossref 18. Goldman HB: Hypoadrenocorticism and endocrinologic treatment of Meniere's disease . NY State J Med 62:377-383, 1962. 19. Trible GB, Trible WM: The problem of Meniere's disease: Causes and management . Eye Ear Nose Throat Monthly 38:389-393, 1959. 20. Williams HL, Hedgecock LD: Citrus bioflavonoid, ascorbic acid, and the B vitamins in the treatment of certain types of neurosensory deafness: Preliminary report . Staff Meetings of the Mayo Clinic 37:474-483, 1962. 21. Williams HL: Eriodictyol glycoside in Meniere's disease . Trans Am Acad Ophthalmol Otolaryngol 68:45-59, 1964. 22. Williams HL: Comments on Meniere's disease . Postgrad Med 36:274-277, 1964. 23. Goffin FB: Lipoflavonoids in Meniere's disease . Eye Ear Nose Throat Monthly 49:290-291, 1970. 24. Creston JE, Gillespie MR, Larson AL: Bioflavonoid therapy in sensori-neural hearing loss: A double-blind study . Trans Am Acad Ophthalmol Otolaryngol 70:825-840, 1966. 25. Thomsen J, Beck P, Geisler A, et al: Meniere's disease: Preliminary report of lithium treatment . Acta Otolaryngol 78:59-64, 1974.Crossref 26. Klockhoff I, Lindblom U: Meniere's disease and hydrochlorothiazide (Dichlortride): A critical analysis of symptoms and therapeutic effects . Acta Otolaryngol 63:347-365, 1967.Crossref 27. Klockhoff I, Lindblom U, Stahle J: Diuretic treatment of Meniere's disease: Long-term results with chlorthalidone . Arch Otolaryngol 100:262-265, 1974.Crossref 28. Densert 0, Ingelstedt S, Iversson A, et al: Immediate restoration of sensorineural hearing (MB Meniere) using a pressure chamber . Acta Otolaryngol 80:93-100, 1975.Crossref 29. Weintraub J, Arenberg IK, Spector GJ, et al: The efficacy of "conservative" medical regimens on the rate of hearing losses in Meniere's syndrome: A retrospective computerized statistical analysis . Laryngoscope 86:1391-1396, 1976.Crossref 30. Schucknecht HF, in discussion: Medical treatment of Meniere's disease . Arch Otorhinolaryngol 212:384, 1976. 31. Klockhoff I: Discussion: Medical treatment of Meniere's disease . Arch Otorhinolaryngol 212:384, 1976.Crossref 32. Torok N: Old and new in Meniere's disease. Presented at the Middle Section Meeting, Triologic Society, Cleveland, Jan 21 to 23, 1977 . Laryngoscope , to be published. 33. Portmann G: Vertigo: Surgical treatment by opening saccus endolymphaticus . Arch Otolaryngol 6:309-319, 1927.Crossref 34. Cawthorne TE, Hallpike CS: Some recent work on the investigation and treatment of Meniere's disease . Proc R Soc Med 36:533-550, 1943. 35. Stahle J: Ultrasound treatment of Meniere's disease: Long-term follow-up of 356 advanced cases . Acta Otolaryngol 81:120-126, 1976.Crossref 36. Wolfson RJ, Cutt RA, Ishiyama E, et al: III. Cryosurgery for Meniere's disease . Laryngoscope 78:632-642, 1968.Crossref 37. Woodman EM: The position of the Portmann operation in relation to labyrinthine vertigo . Proc R Soc Med 32:1642-1645, 1939. 38. Flett RL: The saccus operation in Meniere's disease . Proc R Soc Med 47:672-674, 1954. 39. Portmann M: Decompressive opening of endolymphatic sac . Arch Otolaryngol 79:328-337, 1964.Crossref 40. House WF: Subarachnoid shunt for drainage of hydrops: A report of 246 cases . Laryngoscope 70:1547-1551, 1965.Crossref 41. Austin DF, Hart GR: Short term study of endolymphatic shunt operation . Arch Otolaryngol 81:359-364, 1965.Crossref 42. Clemis JD, Shambaugh GE: Preliminary experiences with operations on the endolymphatic sac . Laryngoscope 76:1029-1041, 1966.Crossref 43. House WF, Owens FD: Long-term results of endolymphatic subarachnoid shunt surgery in Meniere's disease . J Laryngol Otol 87:521-528, 1973.Crossref 44. Gardner G: Endolymphatic sac shunt operation in Meniere's disease . Trans Am Acad Ophthalmol Otolaryngol 80:306-313, 1975. 45. Paparella MM, Hanson DG: Endolymphatic sac drainage for intractable vertigo (method and experience) . Laryngoscope 86:697-703, 1976.Crossref 46. Morrison AW: The surgery of vertigo: Saccus drainage for idiopathic endolymphatic hydrops . J Laryngol Otol 90:87-93, 1976.Crossref 47. Arenberg IK, Spector GJ: Endolymphatic sac surgery for conservation of hearing in Meniere's disease . Arch Otolaryngol 103:268-270, 1977.Crossref 48. Fisch U: Surgical treatment of vertigo . J Laryngol Otol 90:75-93, 1976.Crossref 49. Klockhoff I, Lindblom U: Glycerol test in Meniere's disease . Acta Otolaryngol Suppl 224:449-451, 1967.Crossref 50. Alford BR: Report on subcommittee on equilibrium and its measurements: Meniere's disease: Criteria for diagnosis and evaluation of therapy for reporting results . Trans Am Acad Ophthalmol Otolaryngol 76:1462-1464, 1972. 51. Arenberg IK, Murray JP, Rauchbach E, et al: An experimental model for the study of endolymphatic hydrops in sharks: Implications for the clinician . Laryngoscope 86:1426-1434, 1976.Crossref 52. Shambaugh GE Jr, Clemis JD, Arenberg IK: Endolymphatic duct and sac in Meniere's disease: I. Surgical and histopathologic observations . Arch Otolaryngol 89:816-825, 1969.Crossref 53. Thomas K, Harrison MS: Long term follow up of 610 cases of Meniere's disease . Proc R Soc Med 64:853-857, 1971. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

Therapeutic Options in Meniere's Disease

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Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1977.00780270057007
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Abstract

Abstract • Emphasis on treatment in Meniere's disease has recently shifted from a concentration on the vertiginous component alone to include conservation or improvement of hearing as well. This presentation tabulates the current otological literature's reports of both the medical and surgical options available in the treatment of Meniere's disease. The authors conclude that these more recent reports deemphasize the importance of the vertiginous component, while emphasizing the importance of the hearing component in evaluation of the efficacy of any therapeutic modality. Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. In nonreversible or nonfluctuating hearing deficits with hearing worth conserving, vestibular neurectomy with excision of Scarpa's ganglion yields the best results. (Arch Otolaryngol 103:589-593, 1977) References 1. Hallpike CS, Cairns H: Observations on the pathology of Meniere's syndrome . Proc R Soc Med 31:1317-1336, 1938. 2. Furstenberg AC, Lashmet FH, Lathrop FD: Meniere's symptom complex: Medical treatment . Ann Otol Rhinol Laryngol 43:1035-1047, 1934. 3. Furstenberg AC, Richardson G, Lathrop FD: Meniere's disease: Addenda to medical therapy . Arch Otolaryngol 34:1083-1092, 1941.Crossref 4. Perlman HP, Goldinger JM, Cales JO: Electrolyte studies in Meniere's disease . Laryngoscope 63:640-651, 1953.Crossref 5. Suga F, Snow JB Jr: Cochlear blood flow in response to vasodilating drugs and some related agents . Laryngoscope 79:1956-1979, 1969.Crossref 6. Wilson WH: Intravenous and optimum-dosage histamine therapy in Meniere's disease . Arch Otolaryngol 97:139-141, 1973.Crossref 7. Caparosa RJ: Medical treatment for Meniere's disease . Laryngoscope 73:666-672, 1963.Crossref 8. Elia JC: Double-blind evaluation of a new treatment for Meniere's syndrome . JAMA 196:187-189, 1966.Crossref 9. Bertrand RA: Meniere's disease: Subjective and objective evaluation of medical treatment with betahistine hydrochloride . Acta Otolaryngol Suppl 305:48-69, 1972.Crossref 10. Hicks JJ, Hicks JN, Cooley HN: Meniere's disease . Arch Otolaryngol 86:610-613, 1967.Crossref 11. Wolfson RJ, Myers D, Schlosser WD: Meniere's disease: Treatment with betahistine hydrochloride . Eye Ear Nose Throat Monthly 46:891-896, 1967. 12. Hommes OR: A study of the efficacy of betahistine in Meniere's syndrome . Acta Otolaryngol Suppl 305:70-79, 1972.Crossref 13. Shea JJ, Bowers RE: Diagnosis and treatment of fluctuant hearing loss . Otolaryngol Clin North Am 8:431-438, 1975. 14. Jongkees LBW: Medical treatment of Meniere's disease . Acta Otolaryngol Suppl 192:109-112, 1963. 15. Futaki T, Kitahara M, Morimoto M: Meniere's disease and diphenidol: A critical analysis of symptoms and equilibrium function tests . Acta Otolaryngol Suppl 330:120-128, 1975.Crossref 16. Marlow FI: Drug treatment of Meniere's disease . Otolaryngol Clin North Am 6:119-129, 1973. 17. Boedts DA, Vandenhove PT: Droperidolfentanyl citrate in equilibratory disturbances . Arch Otolaryngol 89:715-719, 1969.Crossref 18. Goldman HB: Hypoadrenocorticism and endocrinologic treatment of Meniere's disease . NY State J Med 62:377-383, 1962. 19. Trible GB, Trible WM: The problem of Meniere's disease: Causes and management . Eye Ear Nose Throat Monthly 38:389-393, 1959. 20. Williams HL, Hedgecock LD: Citrus bioflavonoid, ascorbic acid, and the B vitamins in the treatment of certain types of neurosensory deafness: Preliminary report . Staff Meetings of the Mayo Clinic 37:474-483, 1962. 21. Williams HL: Eriodictyol glycoside in Meniere's disease . Trans Am Acad Ophthalmol Otolaryngol 68:45-59, 1964. 22. Williams HL: Comments on Meniere's disease . Postgrad Med 36:274-277, 1964. 23. Goffin FB: Lipoflavonoids in Meniere's disease . Eye Ear Nose Throat Monthly 49:290-291, 1970. 24. Creston JE, Gillespie MR, Larson AL: Bioflavonoid therapy in sensori-neural hearing loss: A double-blind study . Trans Am Acad Ophthalmol Otolaryngol 70:825-840, 1966. 25. Thomsen J, Beck P, Geisler A, et al: Meniere's disease: Preliminary report of lithium treatment . Acta Otolaryngol 78:59-64, 1974.Crossref 26. Klockhoff I, Lindblom U: Meniere's disease and hydrochlorothiazide (Dichlortride): A critical analysis of symptoms and therapeutic effects . Acta Otolaryngol 63:347-365, 1967.Crossref 27. Klockhoff I, Lindblom U, Stahle J: Diuretic treatment of Meniere's disease: Long-term results with chlorthalidone . Arch Otolaryngol 100:262-265, 1974.Crossref 28. Densert 0, Ingelstedt S, Iversson A, et al: Immediate restoration of sensorineural hearing (MB Meniere) using a pressure chamber . Acta Otolaryngol 80:93-100, 1975.Crossref 29. Weintraub J, Arenberg IK, Spector GJ, et al: The efficacy of "conservative" medical regimens on the rate of hearing losses in Meniere's syndrome: A retrospective computerized statistical analysis . Laryngoscope 86:1391-1396, 1976.Crossref 30. Schucknecht HF, in discussion: Medical treatment of Meniere's disease . Arch Otorhinolaryngol 212:384, 1976. 31. Klockhoff I: Discussion: Medical treatment of Meniere's disease . Arch Otorhinolaryngol 212:384, 1976.Crossref 32. Torok N: Old and new in Meniere's disease. Presented at the Middle Section Meeting, Triologic Society, Cleveland, Jan 21 to 23, 1977 . Laryngoscope , to be published. 33. Portmann G: Vertigo: Surgical treatment by opening saccus endolymphaticus . Arch Otolaryngol 6:309-319, 1927.Crossref 34. Cawthorne TE, Hallpike CS: Some recent work on the investigation and treatment of Meniere's disease . Proc R Soc Med 36:533-550, 1943. 35. Stahle J: Ultrasound treatment of Meniere's disease: Long-term follow-up of 356 advanced cases . Acta Otolaryngol 81:120-126, 1976.Crossref 36. Wolfson RJ, Cutt RA, Ishiyama E, et al: III. Cryosurgery for Meniere's disease . Laryngoscope 78:632-642, 1968.Crossref 37. Woodman EM: The position of the Portmann operation in relation to labyrinthine vertigo . Proc R Soc Med 32:1642-1645, 1939. 38. Flett RL: The saccus operation in Meniere's disease . Proc R Soc Med 47:672-674, 1954. 39. Portmann M: Decompressive opening of endolymphatic sac . Arch Otolaryngol 79:328-337, 1964.Crossref 40. House WF: Subarachnoid shunt for drainage of hydrops: A report of 246 cases . Laryngoscope 70:1547-1551, 1965.Crossref 41. Austin DF, Hart GR: Short term study of endolymphatic shunt operation . Arch Otolaryngol 81:359-364, 1965.Crossref 42. Clemis JD, Shambaugh GE: Preliminary experiences with operations on the endolymphatic sac . Laryngoscope 76:1029-1041, 1966.Crossref 43. House WF, Owens FD: Long-term results of endolymphatic subarachnoid shunt surgery in Meniere's disease . J Laryngol Otol 87:521-528, 1973.Crossref 44. Gardner G: Endolymphatic sac shunt operation in Meniere's disease . Trans Am Acad Ophthalmol Otolaryngol 80:306-313, 1975. 45. Paparella MM, Hanson DG: Endolymphatic sac drainage for intractable vertigo (method and experience) . Laryngoscope 86:697-703, 1976.Crossref 46. Morrison AW: The surgery of vertigo: Saccus drainage for idiopathic endolymphatic hydrops . J Laryngol Otol 90:87-93, 1976.Crossref 47. Arenberg IK, Spector GJ: Endolymphatic sac surgery for conservation of hearing in Meniere's disease . Arch Otolaryngol 103:268-270, 1977.Crossref 48. Fisch U: Surgical treatment of vertigo . J Laryngol Otol 90:75-93, 1976.Crossref 49. Klockhoff I, Lindblom U: Glycerol test in Meniere's disease . Acta Otolaryngol Suppl 224:449-451, 1967.Crossref 50. Alford BR: Report on subcommittee on equilibrium and its measurements: Meniere's disease: Criteria for diagnosis and evaluation of therapy for reporting results . Trans Am Acad Ophthalmol Otolaryngol 76:1462-1464, 1972. 51. Arenberg IK, Murray JP, Rauchbach E, et al: An experimental model for the study of endolymphatic hydrops in sharks: Implications for the clinician . Laryngoscope 86:1426-1434, 1976.Crossref 52. Shambaugh GE Jr, Clemis JD, Arenberg IK: Endolymphatic duct and sac in Meniere's disease: I. Surgical and histopathologic observations . Arch Otolaryngol 89:816-825, 1969.Crossref 53. Thomas K, Harrison MS: Long term follow up of 610 cases of Meniere's disease . Proc R Soc Med 64:853-857, 1971.

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Oct 1, 1977

References