Meniere's Disease

Won Sang Lee; Ja-Won Koo

doi:10.5124/jkma.2008.51.11.1007

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Lee and Koo: Meniere's Disease

Focused Issue of This Month

Diagnosis and Treatment of Dizziness

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(11): 1007-1015.

Published online: 30 November 2008

DOI: https://doi.org/10.5124/jkma.2008.51.11.1007

Meniere's Disease

Won Sang Lee, MD¹, Ja-Won Koo, MD²

¹Department of Otorhinolaryngology, Yonsei University College of Medicine, Korea. wsleemd@yumc.yonsei.ac.kr

²Department of Otorhinolaryngology, Seoul National University College of Medicine, Korea. jawonkoo@snubh.org

Abstract

Hydrops of the endolymphatic space in the inner ear deteriorates hearing and balance function. This idiopathic syndrome of endolymphatic hydrops is Meniere's disease and is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. For the pathophysiologic mechanisms of the episode, the progression of the hydrops leads to ruptures in the membranes separating endolymph from perilymph, producing a sudden increase in potassium concentration in the perilymph. Recurrent episodes may interfere with routine daily activities and sometimes accompany sudden drop attacks, so called Tumarkin's otolithic crisis, which may lead to serious injuries. Life style modification, low salt diet and prescription of diuretics have been traditionally tried in order to relieve endolymphatic hydrops. Surgical and destructive treatment options are necessary in selected intractable patients depending on the frequency of vertigo, severity of hearing loss and the possibility of bilateral involvement. However, a large proportion of these patients shows a spontaneous cure of vertigo with the aggravation of hearing loss (burnt out stage) over time. The goal of treatment is trying not to make the patient worse than this natural course of disease.

Keywords: Meniere's disease, Endolymphatic hydrops, Dizziness, Hearing loss

Figures and Tables

Table 1

Diagnostic guidelines of Meniere's disease (American Academy of Otolaryngology-Head and Neck Surgery, 1995)

References

1. Meniere P. Memoire sur des lesions de l'oreille interne donnant lieu a des symtomes de congestion cerebrale apoplectiforme. Gaz Med Paris. 1861. 38:597–601.

2. Schuknecht HF, editor. Pathology of the Ear. 1993. 2nd ed. Philadelphia: Lea & Febiger;245–275.

3. Brown DH, McClure JA, Downar-Zapolski Z. The membrane rupture theory of Menieres disease-is it valid? Laryngoscope. 1988. 98:599–601.

4. Kiang NYS. Nadol JB, editor. An auditory physiologist's view of Meniere's syndrome. 2nd Int Symp Men Dis. 1989. Amsterdam: Kugler;13–24.

5. Vasama JP, Linthicum FH Jr. Meniere's disease and endolymphatic hydrops without Meniere's symptoms: temporal bone histopathology. Acta Otolaryngol. 1999. 199:297–301.

6. Tasaki I, Fernandea C. Modification of the cochlear microphonics and action potentials by KCI solution and by direct current. J Neurophysiol. 1952. 12:497–512.

7. Dohlmann GF, Johnson WH. Experiments on the mechanism of Meniere's attacks. Proc Can Otol Soc. 1965. 19:73.

8. Dohlmann GF. On the mechanism of the Menière attack. Arch Otorhinolaryngol. 1976. 212:301–307.

9. Schuknecht HF, Igarashi M. Praltz CR, editor. Pathophysiology of Meniere's diease. Controversial Aspects of Meniere's Disease. 1986. New York: Thieme;46–54.

10. Okuno T, Sando I. Localization, frequency, and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in Menière's disease. Ann Otol Rhinol Laryngol. 1987. 96:438–445.

11. Paparella MM. Pathogenesis of Menieres disease and Meniere's syndrome. Acta Otolaryngol. 1984. 406:10–25.

12. Lee WS. Lee WS, Rhee CK, Chung KC, Park BR, Han KC, editors. Meniere's disease. Equilibrium and Disequilibrium. 2005. Seoul: Koonja Publication;475–502.

13. Nadol JB Jr. Positive Hennebert's sign in Meniere's disease. Arch Otolaryngol. 1977. 103:524–530.

14. Shea JJ Jr, Ge X, Warner RM, Orchik DJ. External aperture of the vestibular aqueduct in Meniere's disease. Am J Otol. 2000. 21:351–355.

15. Valvassori GE, Dobben GD. Multidirectional and computerized tomography of the vestibular aqueduct in Meniere's disease. Ann Otol Rhinol Laryngol. 1984. 93:547–550.

16. Hebbar GK, Rask-Andersen H, Linthicum FH Jr. Three-dimensional analysis of 61 human endolymphatic ducts and sacs in ears with and without Menière's disease. Ann Otol Rhinol Laryngol. 1991. 100:219–225.

17. Furuta Y, Takasu T, Fukuda S, Inuyama Y, Sato KC, Nagashima K. Latent herpes simplex virus type 1 in human vestibular ganglia. Acta Otolaryngol Suppl. 1993. 503:85–89.

18. Calenoff E, Zhao JC, Derlacki EL, Harrison WH, Selmeczi K, Dutra JC, Olson IR, Hanson DG. Patients with Menière's disease possess IgE reacting with herpes family viruses. Arch Otolaryngol Head Neck Surg. 1995. 121:861–864.

19. Arnold W, Niedermeyer HP. Herpes simplex virus antibodies in the perilymph of patients with Meniere disease. Arch Otolaryngol Head Neck Surg. 1997. 123:53–56.

20. Gacek RR, Gacek MR. Menière's disease as a manifestation of vestibular ganglionitis. Am J Otolaryngol. 2001. 22:241–250.

21. McCabe BF. Autoimmune sensorineural hearing loss. Ann Otol Rhinol Laryngol. 1979. 88:585–589.

22. Rask-Andersen H, Stahle J. Immunodefence of the inner ear? Lymphocyte-macrophage interaction in the endolymphatic sac. Acta Otolaryngol. 1980. 89:283–294.

23. Arnold W, Altermatt HJ, Gebbers JO. Qualitative detection of immunoglobulins in the human endolymphatic sac. Laryngol Rhinol Otol (Stuttg). 1984. 63:464–467.

24. Yoo TJ, Stuart JM, Kang AH, Townes AS, Tomoda K, Dixit S. Type II collagen autoimmunity in otosclerosis and Meniere's disease. Science. 1982. 217:1153–1155.

25. Koo JW, Oh SH, Chang SO, Park MH, Lim MJ, Yoo TJ. Association of HLA-DR and type II collagen autoimmunity with Meniere's disease. Tissue Antigens. 2003. 61:99–103.

26. Koo JW, Park MH, Oh SH, Yoo TJ, Chang SO, Kim CS. Immunologic screening test and type II collagen autoimmunity in Meniere's disease. J Korean Balance Soc. 2005. 4:13–16.

27. Harris JP. Immunology of the inner ear: evidence of local antibody production. Ann Otol Rhinol Laryngol. 1984. 93:157–162.

28. Kotimaki J, Sorri M, Aantaa E, Nuutinen J. Prevalence of Meniere disease in Finland. Laryngoscope. 1999. 109:748–753.

29. Wladislavosky-Waserman P, Facer GW, Moleri B, Kurland LT. Meniere's disease: A 36-year epidemiologic and clinical study in Rochester. Laryngoscope. 1984. 94:1098–1102.

30. Stahle J, Stahle C, Arenberg K. Incidence of Meniere's disease. Arch Otolaryngol. 1978. 104:99–102.

31. Watanabe Y, Mizukoshi K, Shojaku H, Watanabe I, Hinoki M, Kitahara M. Epidemiological and clinical characteristics of Meniere's disease in Japan. Acta Otolaryngol. 1995. 519:206–210.

32. Cawthorne T, Hewlett AB. Meniere's disease. Proc R Soc Med. 1954. 47:663–670.

33. Okafor BC. Incidence of Meniere's disease. J Laryngol Otol. 1984. 98:775–779.

34. Costa SS, Sousa LCA, Toledo Piza MR. Meniere's disease: overview, epidemiology and natural history. Otolaryngol Clin N Am. 2002. 35:455–495.

35. Paparella MM. The cause (multifactorial inheritance) and pathogenesis (endolymphatic malabsorption) of Meniere's disease and its symptoms (mechanical and chemical). Acta Otolaryngol. 1985. 99:445–451.

36. Meyerhoff WL, Paparella MM, Shea D. Meniere's disease in children. Laryngoscope. 1978. 88:1504–1511.

37. Stahle J, Bergmann B. The caloric reaction in Meniere's disease. Laryngoscope. 1967. 77:1629–1643.

38. Balkany T, Sires B, Arenberg I. Bilateral aspects of Meniere's disease: an underestimated clinical entity. Otolaryngol Clin N Am. 1980. 13:603–609.

39. Thomas K, Harrison MS. Long-term follow-up of 610 cases of Meniere's disease. Proc R Soc Med. 1971. 64:853–856.

40. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995. 113:181–185.

41. Eggermont JJ. Ruben RJ, Elberling C, Salomon G, editors. Summating potentials in electrocochleography: Relation to hearing disorders. Electrocochleography. 1967. Baltimore: University Press;67–88.

42. Eggermont JJ, Odenthal DW. Methods in electrocochleography. Acta Otolaryngol. 1974. 316:s. 17–24.

43. Arts HA, Kileny PR, Telian SA. Dianostic test for endolymphatic hydrops. Otolaryngol Clin North Am. 1997. 30:987–1005.

44. Paparella MM. Filipo R, Barbara M, editors. The natural course of Meniere's disease. Proc 3rd Int Symp Men Dis. 1994. Amsterdam: Kugler;29–40.

45. McClure JA, Copp JC, Lycett P. Recovery nystagmus in Meniere's disease. Laryngoscope. 1981. 91:1727–1737.

46. Tumarkin A. Otolithic catastrophe, a new syndrome. Br Med J. 1936. 2:175–177.

47. Owen Black F, Effron MA, Burns DS. Diagnosis and management of drop attacks of vestibular origin: Tumarkin's otolithic crisis. Otolaryngol Head Neck Surg. 1982. 90:256–262.

48. Torok N. Old and new in Meniere disease. Laryngoscope. 1977. 87:1870–1877.

49. Naganuma H, Kawahara K, Tokumasu K, Okamoto M. Water may cure patients with Meniere disease. Laryngoscope. 2006. 116:1455–1460.

50. Claes J, Van de Heyning PH. Medical treatment of Meniere's disease: a review of literature. Acta Otolaryngol. 1997. 526:s. 37–42.

51. Schmidt JT, Huizing EH. The clinical drug trial in Meniere's disease with emphasis on the effect of betahistine SR. Acta Otolaryngol. 1992. 497:s. 1–189.

52. Tumarkin A. Thoughts on the treatment of labyrinthopathy. J Laryngol Otol. 1966. 80:1041–1053.

53. Densert B, Densert O, Arlinger S, Sass K, Odkvist L. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Menière's disease: a clinical placebo-controlled study. Am J Otol. 1997. 18:726–733.

54. Thomsen J, Bretlau P, Tos M, Johnsen NJ. Placebo effect in surgery for Meniere's disease. A double-blind, placebo-controlled study on endolymphatic sac shunt surgery. Arch Otolaryngol. 1981. 107:271–277.

55. Arenberg IK, Serkowsky M, Mihalco L, Wu CM, Moorhead JF. Filipo R, Barbara M, editors. Danish sham surgery recisited: Intraoperative electrocobhleographic evidence that mastoidectomy/drilling actibely changes hydrops. Proc 3rd Int Symp Men Dis. 1994. Amsterdam: Kugler;533–536.

56. Schuknecht HF. Ablation therapy in the management of Meniere's disease. Acta Otolaryngol. 1957. 132:s. 1–42.

57. Pender DJ. Gentamicin tympanoclysis: effects on the vestibular secretory cells. Am J Otolaryngol. 1985. 6:358–367.

58. Chia SH, Gamst AC, Anderson JP, Harris JP. Intratympanic gentamicin therapy for Ménière's disease: a meta-analysis. Otol Neurotol. 2004. 25:544–552.

59. McKee GJ, Kerr AG, Toner JG, Smyth GD. Surgical control of vertigo in Meniere's disease. Clin Otolaryngol Allied Sci. 1991. 16:216–227.

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