جستجوی مقالات مرتبط با کلیدواژه « meniere's disease » در نشریات گروه « پزشکی »

Meniere's disease is an inner ear disorder not associated with central brain structure involvement. Although the ECochG test has been commonly used to diagnose Meniere's disease recently, it has not demonstrated high sensitivity. Therefore, it is recommended that other complementary tests alongside the ECochG test be used to diagnose Meniere's disease. The SVV test has gained popularity recently for this reason, and in this study, it was decided to use the SVV test in both static and dynamic modes, along with the ECochG test, as a tool for diagnosing Meniere's disease and evaluating its diagnostic features. The study was conducted on 53 patients with confirmed unilateral Meniere's disease and a normal group. Means were calculated with a 95% confidence interval for the groups, and the corresponding graphs were plotted. Independent t-tests were used to examine the difference in SVV results between the normal and Meniere's groups. The ROC curve was then used to determine the cutoff point and calculate. After investigating the cutoff point for the three SVV conditions (tilted towards the lesion), a cutoff point of 2.1 degrees with a sensitivity and specificity of approximately 0.7 was identified as the best condition for distinguishing the Meniere's group from the healthy group. Finally, based on the findings, it can be concluded that the SVV test has relatively low sensitivity for diagnosing Meniere's disease. Therefore, more than relying solely on its results to identify Meniere's disease is required, and it is suggested that other measures alongside the ECochG and SVV tests be included in future studies for further investigation.

Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere’s disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears.

This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32–60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated.

The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of 250, 500, and 1000 Hz.

MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise.

Meniere's disease (MD) is one of the inner ear disorders associated with fluctuating hearing loss, vertigo, ear fullness, and tinnitus. Vestibular stimulation delas with the integrity of the peripheral vestibular system and may cause nystagmus due to the functional asymmetry between right and lef peripheral vestibular system. This study aimed to assess the vibration-induced nystagmus (VIN) in patients with chronic unilateral MD and investigate the effectiveness of this test in detecting the affected ear in these patients.

This study was conducted on 29 patients with chronic unilateral MD. For this purpose, spontaneous nystagmus (SN) and VIN at frequencies of 30 Hz and 100 Hz were recorded by videonystagmography test under five recording conditions. The vibratory stimulation was presented to both healthy and affected ears. Collected were analyzed in SPSS v.22 software.

Vibratory stimulation compared to the unstimulated condition, revealed a significant difference in eye movements for both healthy and affected ears. Moreover, the difference between VIN and SN in the affected ear was much greater than in the healthy ear.

In patients with chronic unilateral MD, 100 Hz vibratory stimulation of the affected ear induces more reliable nystagmus than 30 Hz stimulation and unstimulated condition. The VIN test can be used for the evaluation of the vestibular system function and is a promising technique to detect the MD ear.

 Intratympanic therapy, as a widely used treatment for inner ear diseases, is regarded as a therapeutic method in controlling the vertigo of the patients with Meniere’s disease. This study was designed to evaluate the effect of the Intratympanic dexamethasone-hyaluronic acid combination on patients suffering from Meniere’s disease.   This study was a clinical trial on patients with Meniere’s disease during 2016-2017. Patients received two Intratympanic injections of dexamethasone plus hyaluronic acid as a mixture within a month. Before and 2 weeks after the intervention, pure tone average (PTA) at 0.5, 1, 2, and 4 KHz frequencies, speech discrimination score (SDS), dizziness handicap inventory (DHI), and tinnitus handicap inventory (THI) scores were evaluated for each patient. The obtained scores were statistically analyzed.   This study was conducted on a total number of 25 patients with Meniere's disease. The mean age of participants in this study was 44.71±4.92 years. Gender distribution among participants revealed that 36% of patients were male. The mean values of PTA, SDS, and THI were not significantly different before and after the intervention. However, the mean score of DHI decreased significantly after the intervention (P<0.001).   Intratympanic dexamethasone/hyaluronic acid had a positive effect on the vertigo of the investigated patients without any significant improvement in hearing impairment and tinnitus in the short term.

Bilateral Meniere’s disease presents with attacks of vertigo leading to severe imbalance and oscillopsia. Sometimes, treatment of bilateral Meniere’s disease is challenging. The following case report presents an appropriate and successful management for a complicated Bilateral Meniere’s disease. Patient was a 42 years male referred with severe attacks of vertigo, severe to profound bilateral hearing loss and severe tinnitus as well as imbalance. Vestibular assessment was done with electronystagmography, head impulse test, cervical and ocular vestibular evoked myogenic potential that showed bilateral and widespread vestibular abnormality in the semicircular canals and otolith systems. Patient had different medical treatments before referring to us and we started some medical and rehabilitation treatments based on his unstable conditions and followed him up for over three years. Vestibular rehabilitation is an approach for the management of many vestibular abnormalities such as Meniere’s disease. It could help to resolve vertigo and imbalance in acute and chronic stage of Meniere’s disease. Vestibular rehabilitation may be helpful in controlling the acute symptoms and helps to improve imbalance and oscillopsia.

Meniere’s disease is one of the most common inner ear and vestibular disorders. Its conventional treatment gives unsatisfying results in some cases. This article introduces a patient with Meniere’s disease who has been treated with Persian medicine. The patient was a 40-year-old woman, a known case of Meniere’s disease, who was advised to consume cinnarizine and betahistine. Due to lack of satisfactory response to treatment, the patient referred to Persian medicine clinic. She followed the recommendations of Persian medicine and the disease was completely recovered. Treatment of Meniere's disease in this patient was based on lifestyle modification, warming up the body, strengthening the brain and the nervous system, enhancing the digestive system, modifying the condition of defecation, and removing waste materials and accumulated humors from the body, especially the head. It is believed that this case report will provide a basis for further studies on the impact of Persian medicine on the treatment of Meniere’s disease.

Despite some proposed roles for the diagnostic impact of the cervical vestibular evoked myogenic potential test in the patients with Meniere’s disease, the role of this test as an objective instrument in following up the patients with Meniere’s disease who underwent. Intratympanic steroid injection is not cleared. In a prospective study, thirty-one adult patients with definite one-sided Meniere's disease with vertigo as main complaint refractory to medical treatments for three months, were selected. Patients underwent three times of intratympanic dexamethasone injection with one-week intervals. We performed cervical vestibular evoked myogenic potential test at first and four weeks after the last injection for all participants. We followed the patients for one year. The study results were analyzed with the chi-square test. Cervical vestibular evoked myogenic potential test could not be recorded in 26 patients (83.9%), and the test results were abnormal in the remaining 5 patients. The results were abnormal in the healthy ear of 32.3% of the patients. Despite the clinical improvement of the symptoms after intratympanic injection, the test results were not changed. Cervical vestibular evoked myogenic potential test could not be recorded in the majority of the patients with Meniere's disease; while it is usually recorded in normal ears. On the other hand, results of the cervical vestibular evoked myogenic potential test do not change during the early phase after treatment and could not be a good option for follow up and evaluating the response in this situation.

Vestibulo-ocular reflex (VOR) gain is the central variable for estimating VOR function, and there are several algorithms to calculate gain. The current study aimed to investigate the ability of VOR instantaneous gain and velocity regression as a possible physiological biomarker for differentiating peripheral vestibular disorders of various etiologies.
Video head impulse test (vHIT) was performed on 27 healthy volunteers (normal group) and 29 patients (pathologic group) including three types of peripheral vestibulopathies including unilateral Meniere's disease, unilateral superior vestibular neuritis, and bilateral vestibulopathy.
Analyses indicated that the mean VOR instantaneous gain at 40 ms, 60 ms, 80 ms, and velocity regression at 100 ms differred significantly within the normal and pathologic groups. Also, complete normative data for VOR at 40 ms, 60 ms, and 80 ms instantaneous gain has been provided for the vHIT.
The findings of this study suggest that different vestibular pathologies have a distinct effect on cupular-endolymph function, which could be tracked by VOR dynamic changes.

Meniere’s disease (MD) is a disease of the inner ear that presents itself with repeated episodes of vertigo (96.2%), tinnitus (91.1%), and sensorineural hearing loss (87.7 %). In this article we sought to assess the effects of intratympanic (IT) injections of dexamethasone on definite cases of MD using electrocochleography (ECOG).
In this hospital-based case series in 36 patients, we measured audiometric values and ECOG in all patients before, 1 month and 6 months after 4-mg/mL IT injections of dexamethasone.
Four patients (11%) had improved hearing following the intervention. No difference in pure tone audiometry (PTA) was observed following IT injections (P=0.492), while speech discrimination score (SDS) was significantly improved (P=0.008). There was a significant improvement in vertigo 1 month after IT injections (P IT dexamethasone injections can improve vertigo in definite cases of MD, although it seems that the effect is only temporary.

Subjective visual vertical (SVV) test is a clinical tool to evaluate the utricular function and the gravity perception pathways in peripheral and central vestibular lesions. Meniere’s disease (MD) involves cochlear and otolithic organs. The prevalence and features of otolithic dysfunction in the acute phase of this disease are unknown. The aim of this study was to evaluate of SVV test in the acute phase of MD and to investigate the validity of SVV test for detection of otolithic disorders in MD patients.
Thirty two patients with unilateral definite Meniere's disease and thirty two normal subjects were enrolled in this study. Pure tone audiometry, tympanometry, and SVV test were performed.
There was no significant difference between the mean SVV in the normal group and the mean SVV in the healthy side of the patient group, while a significant difference was observed between the mean SVV in the normal group and the mean SVV in the affected side of the patient groups. Also, in the patient group, the difference in the mean SVV between the healthy and affected sides was significant.
Patients with MD have difficulties in perception of verticality that is probably due to utricular dysfunction. In order to improve the level of diagnosis of MD it is suggested to add SVV test to the test battery.

Meniere’s disease is the disorder of inner ear characterized by vertigo, tinnitus and sensorineural hearing loss. The vestibular evoked myogenic potential (VEMP) test could be useful in the analysis of saccular function, and diagnosis of Meniere’s disease. In this study, we’ve analyzed the saccular function, using VEMP test in different groups of Meniere’s disease. Patients were categorized as possible, probable or definite Meniere’s disease groups according to the guideline of American Academy of Otolaryngology-Head and Neck Surgery. The exclusion criteria were neuromuscular system diseases, diseases of central nervous system, inner ear disorders, conductive hearing loss, a history of ototoxic drug consumption, being a drug abuser and a positive history of inner ear surgery or manipulations. The VEMP test is the recording of positive and negative waves from sternocleidomastoid muscle that is made by an auditory click to the ear. From the total of 100 patients, the waves of VEMP test was seen in 59 patients which 19 patients had abnormal amplitude, and latency and 40 patients were with normally recorded waves. There was a significant relationship between the severity of hearing loss and a VEMP test without any recorded waves. Most of the cases with ‘no wave recorded’ VEMP test, were patients with severe hearing loss. However, there wasn’t any relation between the pattern of hearing loss and ‘no wave recorded’ VEMP test. VEMP test could be a valuable diagnostic clue especially in patients with definite Meniere’s disease.

Several lines of evidence support the contribution of autoimmune mechanisms in the pathogenesis of Meniere’s disease. The aim of this study was determining the association between HLA-Cw Alleles in patients with definite Meniere’s disease and patients with probable Meniere’s disease and a control group.
HLA-Cw genotyping was performed in 23 patients with definite Meniere’s disease, 24 with probable Meniere’s disease, and 91 healthy normal subjects, using sequence specific primers polymerase chain reaction technique. The statistical analysis was performed using stata 8 software.
There was a significant association between HLA-Cw*04 and HLA-Cw*16 in both definite and probable Meniere’s disease compared to normal healthy controls. We observed a significant difference in HLA-Cw*12 frequencies between patients with definite Meniere’s disease compared to patients with probable Meniere’s disease (P=0.04). The frequency of HLA-Cw*18 is significantly higher in healthy controls (P=0.002).
Our findings support the rule of HLA-Cw Alleles in both definite and probable Meniere’s disease. In addition, differences in HLA-Cw*12 frequency in definite and probable Meniere’s disease in our study’s population might indicate distinct immune and inflammatory mechanisms involved in each condition.

Incidence rates of Meniere's disease vary considerably from 157/100,000 in the United Kingdom to 15/100,000 in the United States. Furthermore, in Iran prevalence of Meniere's disease is high, whereas we have not a reliable statistical study on it. A wide range of treatments are used for the treatment of the condition with no consensus on the most effective intervention. The aim of the present study, which involved 37 patients treated because of severe vertigo due to persistent Meniere's disease from 1996 to 2011, was to compare the effectiveness of two surgical methods cochleosacculotomy and endolymphatic sac decompression on vertigo and tinnitus.

In a cross-sectional study, we compared two surgical approaches in patients with Meniere's disease who did not respond to usual medical treatment. Twenty-three patients underwent cochleosacculotomy surgery and 14 patients endolymphatic sac decompression surgery. We compared all the patients for resolving of vertigo, tinnitus.

After surgery, in patients of both group vertigo was improved significantly (P < 0.0001), tinnitus was improved, but it was not significant (P > 0.05) and hearing level was worse than before (especially in patients who had undergone cochleosacculotomy) (P < 0.0001).

Based on the data of the current study, cochleosacculotomy and endolymphatic sac decompression improved vertigo in patients with persistent Meniere's disease.

Ménière’s disease has been remained as a difficult therapeutic challenge. The present study aimed to determine the effects of one-shot low-dosage intratympanic gentamicin on vertigo control, auditory outcomes and findings of computerized dynamic posturography and vestibular evoked myogenic potentials in patients with unilateral Ménière’s disease. In a prospective clinical study, 30 patients with unilateral Ménière’s disease were treated with one-shot intratympanic injection of 20 milligrams gentamicin. Main outcome measures included clinical, audiometric, postural and vestibular outcomes evaluated 1 and 9 months after the treatment. Mean vertigo attacks frequency, pure tone average threshold and functional level scale significantly decreased after the treatment (P < 0.05). Effective vertigo control (class A and B) obtained in 95.8% of the patients. In total, 75% of patients reported decrease in both aural fullness and tinnitus. Vestibular evoked myogenic potentials became absent in all the patients but four of them. Posturographic scores were improved after the treatment. One-shot low-dosage gentamicin was effective in controlling vertigo attacks in Ménière’s disease and has useful effects on aural fullness and tinnitus of patients as well. Postural and vestibular tests only have adjunctive role for monitoring therapeutic responses in intratympanic gentamicin-therapy.