Medical management of Ménière’s disease: a 10-year case series and review of literature

• Published in: European archives of oto-rhino-laryngology 2010-09, Vol.267 (9), p.1371-1376
• Main Authors: Martín González, C., González, F. M., Trinidad, A., Ibáñez, A., Pinilla, M., Martínez Ruiz-Coello, A., Rodríguez Valiente, A., López-Cortijo, C.
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Aminoglycosides - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Betahistine - therapeutic use; Biological and medical sciences; Caloric Tests; Combined Modality Therapy; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Electronystagmography; Female; Head and Neck Surgery; Histamine Agonists - therapeutic use; Humans; Hypnotics and Sedatives - therapeutic use; Male; Medical sciences; Medicine; Medicine & Public Health; Meniere Disease - diagnosis; Meniere Disease - drug therapy; Middle Aged; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Neurosurgery; Non tumoral diseases; Otology; Otorhinolaryngology; Otorhinolaryngology. Stomatology; Pharmacology. Drug treatments; Postural Balance - drug effects; Retrospective Studies; Vasodilator Agents - therapeutic use; Vestibule, Labyrinth - drug effects
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-010-1265-4

Ménière’s disease is frequent in our area. It is a disabling pathology that affects the patient’s quality of life. Its etiology and pathophysiology remain unclear and there are some therapeutic alternatives with controversial results. We present our series and treatment protocol for Ménière’s disease and discuss the current evidence regarding its medical treatment. In the last 10 years, 252 patients were diagnosed with Ménière’s disease based on their symptoms, and the results of tonal audiometry, videonystagmography and caloric stimulation tests. All cases received medical treatment according to our management protocol. Ménière’s disease is more frequent in women (54.76%); 83.73% of cases are unilateral. Among these, vertigo was observed in 93.7%, hearing loss in 88.1%, tinnitus in 86.1% and pathologic caloric stimulation tests in 71% (88.27% with a reduced vestibular response). A 5-year follow-up was performed in 89.6% of the patients. Subjective improvement as reported by patients was achieved in 94.4% of the cases. There is great controversy about the medical treatment of Ménière’s disease. We found no evidence for the most adequate medical treatment among the different alternatives described in literature. The patient’s acceptance and understanding of the disease is very important.