Bermúdez-Tirado NK, Zazueta-López IB, Celis-Aguilar EM, Castro-Urquizo Á

Language: Spanish
References: 27
Page: 75-83
PDF size: 413.22 Kb.

ABSTRACT

Background: Ménière’s disease is a common cause of peripheral vertigo in the clinic. To this date there are no consensus on its treatment.
Objective: To evaluate the current management practices in Ménière’s disease.
Material and Method: A cross-sectional study was carried out from October 2017 to January 2018 by means of anonymous questionnaire to Mexican neurotologists.
Results: Twenty-six responses of Mexican neurotologists were obtained, 73.1% were men with a mean age of 46.2 years. According to survey results, medical treatment was the principal choice in a patient with functional class 2 and 3, dietary salt restriction (84.6%), diuretics such as acetazolamide (53.8%) and calcioantagonists (50%). In Ménière’s disease functional class 4-6 intratympanic steroids (56.6%) were mainly used in patients with preserved hearing and intratympanic gentamicin was prescribed in 55% in patients with non-preserved hearing. Refractory Ménière’s disease with preserved hearing was treated with intratympanic medications in 73% and the surgery most commonly performed was endolymphatic sac procedure (19.2%). Refractory Ménière’s disease with non-preserved hearing was treated with intratympanic gentamicin (38.4%) and 23% with labyrinthectomy.
Conclusion: The survey showed a preference towards the use of intratympanic therapy in Ménière’s disease of functional class 4 to 6 and refractory Ménière’s disease.

REFERENCES

1. Centro Nacional de Excelencia Tecnológica en Salud. Diagnóstico y Tratamiento de la Enfermedad de Ménière en los tres niveles de atención. México: Secretaría de Salud; 27/07/2018; adquirido el 12 diciembre 2018 de: http:// cenetec-difusion.com/gpc-sns/?p=975

2. Saenz AM. Enfermedad de Ménière. Rev Otorrinolaringol Cir Cab Cuello 2002;62:289-98.

3. Awuah P, Duah IM. Trends of Meniere’s disease In Ghana. J Biol Agric Healthc 2012;2(6):1-6.

4. Lalwani A, Jason QZ, McGuire JF. Pharmacologic and molecular therapies of the cochlear and vestibular labyrinth. In: Flint PW, Haughey BH, Lund VJ, et al, editors. Cummings Otolaryngology - Head and Neck Surgery. Philadelphia: Mosby; 2010;2179-93.

5. Lopez-Escamez J, Carey J, Chung WH, et al. Diagnostic criteria for Ménière’s disease. J Vestib Res 2015;25(1):1-7.

6. Bianchi MV. Tratamiento de la enfermedad de Menière. Rev FASO 2015; S22(1):69-74.

7. Wladislavosky-Waserman P, Facer GW, Mokri B, Kurland LT. Meniere’s disease: a 30-year epidemiologic and clinical study in Rochester, MN, 1951-1980. Laryngoscope 1984;94(8):1098-102.

8. Paparella MM, Djalilian HR. Etiology, pathophysiology of symptoms, and pathogenesis of Meniere’s disease. Otolaryngol Clin North Am 2002 Jun; 35(3):529-45.

9. Luxford E, Berliner KI, Lee J, Luxford WM. Dietary modification as adjunct treatment in Ménière's disease: patient willingness and ability to comply. Otol Neurotol 2013 Oct;34(8):1438-43.

10. Hussain K, Murdin L, Schilder AGM. Restriction of salt intake and other dietary modifications for the treatment of Ménière’s disease or syndrome. Cochrane Database of Syst Rev. 2016;5:CD012173.

11. Clyde JW, Oberman BS, Isildak H. Current management practices in Ménière’s disease. Otol Neurotol 2017;38(6):159-67.

12. Burgess A, Kundu S. Diuretics for Ménière’s disease or syndrome. Cochrane Database of Syst Rev 2006;3:CD003599.

13. Albera R, Ciuffolotti R, Di Cicco M, et al. Double-blind, randomized, multicenter study comparing the effect of betahistine and flunarizine on the dizziness handicap in patients with recurrent vestibular vertigo. Acta Otolaryngol 2003;123(5):588-93.

14. Lacour M, van de Heyning PH, Novotny M, Tighilet B. Betahistine in the treatment of Ménière's disease. Neuropsychiatr Dis Treat 2007 Aug;3(4):429-40.

15. Adrion C, Fischer CS, Wagner J, Gürkov R, Mansmann U, Strupp M. Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial). BMJ 2016 Jan;352:1-16.

16. van Esch BF, van der Zaag-Loonen HJ, Bruintjes T, Murdin L, James A, van Benthem P. Betahistine for Ménière’s disease or syndrome. Cochrane Database of Syst Rev 2018;1:CD012914.

17. Pullens B, van Benthem PP. Intratympanic gentamicin for Ménière's disease or syndrome. Cochrane Database of Syst Rev 2011;3:CD008234.

18. McFeely WJ, Singleton GT, Rodriguez FJ, Antonelli PJ. Intratympanic gentamicin treatment for Meniere's disease. Otolaryngol Head Neck Surg 1998;118(5):589-96.

19. Silverstein H, Isaacson JE, Olds MJ, Rowan PT, Rosenberg S. Dexamethasone inner ear perfusion for the treatment of Meniere’s disease: a prospective, randomized, doubleblind, crossover trial. Am J Otol 1998;19(2):196-201.

20. Bayazit Y. Hearing results of intratympanic steroid treatment of endolymphatic hydrops. Laryngoscope 2001 Jun;111(6):1114-5.

21. Patel M. Intratympanic corticosteroids in Ménière’s disease: a mini-review. J Laryngol Otol 2017 Sep;12(3):117-24.

22. Boleas AM, Lin FR, Della SC, Minor LB, Carey JP. Longitudinal results with intratympanic dexamethasone in the treatment of Ménière’s disease. Otol Neurotol 2008;29(1):33-8.

23. Phillips JS, Westerberg B. Intratympanic steroids for Ménière’s disease or syndrome. Cochrane Database of Syst Rev 2011 Jul;7:CD008514.

24. Thomsen J, Bonding P, Becker B, Stage J, Tos M. The nonspecific effect of endolymphatic sac surgery in treatment of Meniere’s disease: a prospective, randomized controlled study comparing “classic” endolymphatic sac surgery with the insertion of a ventilating tube in the tympanic membrane. Acta Otolaryngol 1998;118(6):769-73.

25. Bretlau P, Thomsen J, Tos M, Johnsen NJ. Placebo effect in surgery for Ménière’s disease: nine-year follow-up. Am J Otol 1989;10(4):259-61.

26. Pullens B, Verschuur HP, van Benthem PP. Surgery for Ménière’s disease. Cochrane Database of Syst Rev 2013;(2):CD005395.

27. Smith WK, Sankar V, Pfleiderer AG. A national survey amongst UK otolaryngologists regarding the treatment of Meniere’s disease. J Laryngol Otol 2005;119(2):102-105.