Trends in the diagnosis and the management of Meniere's disease: Results of a survey

被引:27
作者
Kim, HH
Wiet, RJ
Battista, RA
机构
[1] Wilson Ear Clin, Portland, OR USA
[2] Chicago Otol Grp, Hinsdale, IL USA
[3] Northwestern Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Chicago, IL 60611 USA
关键词
D O I
10.1016/j.otohns.2005.01.007
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
OBJECTIVE: To determine the practices of the American Neurotology Society (ANS) membership in the evaluation and treatment of the Meniere's patient. STUDY DESIGN: Prospective. INTERVENTION: Questionnaire. MAIN OUTCOME MEASURE. Respondents' response to questions pertaining to the diagnostic and therapeutic practices in the management of Meniere's disease. RESULTS. Three hundred members of ANS were mailed a 15-item questionnaire. Two hundred three responded, for a 67.7% response rate. For the diagnosis of Meniere's disease, I in 3 practitioners relied solely on history, physical exam, and audiometry, whereas 2 in 3 relied in part on adjunctive tests, such as electrocochleography (ECOG) and electronystagmography (ENG). Two in 3 practitioners pursued retrocochlear studies on initial evaluation, with the overwhelming majority using MRI. In treating Meniere's disease, conservative medical management was preferred. For medically recalcitrant Meniere's disease, endolymphatic sac surgery (ESS) was the most commonly employed initial intervention (50%), followed by transtympanic gentamicin (38%). Currently, < 10% routinely recommend the Meniett device. Eighty-three percent include ESS as a therapeutic option for medically recalcitrant Meniere's disease. The vast majority continue to perform surgical labyrinthectomies and vestibular nerve sections for Meniere's disease. CONCLUSIONS: Meniere's disease continues to pose a difficult diagnostic and therapeutic problem, resulting in heterogeneous approaches to both evaluation and treatment. Despite the 1995 American Academy of Otolaryngology guidelines in the diagnosis of Meniere's disease, most clinicians rely in part on ENG or ECOG in diagnosing Meniere's disease. Furthermore, despite the passing of 20 years since the publications claiming a purely placebo effect, ESS is the most commonly employed initial surgical treatment for Meniere's disease.
引用
收藏
页码:722 / 726
页数:5
相关论文
共 19 条
  • [11] Intratympanic gentamicin for intractable Meniere's disease
    Perez, N
    Martín, E
    García-Tapia, R
    [J]. LARYNGOSCOPE, 2003, 113 (03) : 456 - 464
  • [12] SUMMATING-POTENTIAL ACTION-POTENTIAL RATIO IN NORMAL EARS - EFFECTS OF DEHYDRATION
    RIDENOUR, BD
    MEYERHOFF, WL
    WANG, XB
    GERKEN, GM
    [J]. AMERICAN JOURNAL OF OTOLARYNGOLOGY, 1993, 14 (01) : 24 - 30
  • [13] Medical management of Meniere's disease
    Sajjadi, H
    [J]. OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA, 2002, 35 (03) : 581 - +
  • [14] DIURETIC AND DIET EFFECT ON MENIERES-DISEASE EVALUATED BY THE 1985 COMMITTEE ON HEARING AND EQUILIBRIUM GUIDELINES
    SANTOS, PM
    HALL, RA
    SNYDER, JM
    HUGHES, LF
    DOBIE, RA
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 1993, 109 (04) : 680 - 689
  • [15] Silverstein Herbert, 2003, Ear Nose Throat J, V82, P185
  • [16] THOMSEN J, 1981, ARCH OTOLARYNGOL, V107, P271
  • [17] TOROK N, 1977, LARYNGOSCOPE, V87, P1870
  • [18] Endolymphatic mastoid shunt: A reevaluation of efficacy
    Welling, DB
    Nagaraja, HN
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2000, 122 (03) : 340 - 345
  • [19] WEXLER DB, 1991, LARYNGOSCOPE, V101, P50