The objectives were to analyze the Internal Jugular vein entrapment caused by muscles compression and the possible role and correlation in Mèniére disease. We describe the eco-color Doppler evaluation of a sternocleidomastoid and omohyoid muscles compression of internal jugular vein in a Mèniére patient, responsible of an anomalous venous cerebral and ear outflow. The proposed treatment was a three months muscolar decontractration physiotherapy program. The physiotherapy session allowed a complete muscles relaxation with an improvement of Internal Jugular vein caliber associated to a normalized cerebral and inner ear venous outflow and a progressive attenuation of Mèniére symptoms during the treatment and its disappearance at the end of the physiotherapy program. The comfort of the patient was confirmed during one-year follow-up. Muscles entrapment of Internal Jugular veins may be correlated with an anomalous cerebral and inner ear venous outflow, promoting the Mèniére disease symptoms. Physiotherapy treatment may represent an intriguing option alternatively of muscle surgical. The present case seems to indicate a possible first line treatment by physiotherapy, reserving surgical resection to not responders. Further studies with a wider sample of patients are warranted.

Identification techniques of the three different chronic cerebrospinal venous insufficiency patterns and related treatment options are in an initial phase of evaluation and analysis. Our purpose is to describe the appropriate management, proposing a tailored approach for each one. We identified three different Ménière syndrome patients in our Audiology Department, diagnosing the corresponding chronic cerebrospinal venous insufficiency pattern by Echo-color Doppler ultrasound evaluation and treating by venous angioplasty or rehabilitative treatment according to the internal jugular and vertebral veins anomalies found in each patient. According to the pattern, after specific treatment, echo-color-Doppler control analysis revealed a normalized venous outflow correlated to Ménière symptoms reduction and/or progressive disappearance during one year follow up. An adequate analysis of venous cerebral and ear outflow and a tailored treatment may represent an effective option when chronic cerebrospinal venous insufficiency is correctly diagnosed.