To assess how effectively the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium (AAO-HNS CHE) guidelines for the diagnosis and evaluation of therapy in Meniere's disease have been applied in the last 11 years of published literature. This was a MedLine-based review. Some 79.7% of papers attempted to use the AAO-HNS CHE guidelines. However, only 50% of these publications managed to use the AAO-HNS CHE criteria in the diagnosis and evaluation of therapy correctly. In order to advance our understanding of this condition, improved application of the AAO-HNS CHE guidelines by authors and editors alike is required in the reporting of results of the therapy of Meniere's disease.

The aim of this study was to determine which anaesthetic and vasoconstrictor preparations UK Otorhinolaryngologists use for rhinological surgery, with particular reference to cocaine and adrenaline. The incidence and types of adverse reactions to cocaine were also recorded. A postal survey of all BAO-HNS consultant members was performed. Of the 360 consultant surgeons included in the survey, the majority still use peri-operative cocaine on a regular basis, 66 per cent use cocaine and adrenaline together and more than 40 per cent use cocaine in paediatric patients. Sixteen per cent of respondents did not use cocaine. Only 11 per cent of surgeons had experienced cocaine toxicity in their patients, with only one recorded case of mortality. Most surgeons in the UK use cocaine because of the superior operative field it provides and because they consider it to be safe even with adrenaline. The actual incidence of adverse reactions to cocaine is low, with serious complications being less common than the risks from general anaesthesia. Cocaine remains a valuable agent in the armamentarium of the rhinologist.

Debate surrounding the need for evidence-based research in all fields of otolaryngology has recently emerged. A review of English language articles dealing with the treatment of Menière's disease published from 1989 to 1999 was performed. The papers were classified according to article type (observational studies, non-clinical studies, controlled trials, randomised controlled trials) and according to the grade of evidence that was offered. A total of 128 publications were reviewed, of which only three were randomised controlled trials and a further three were well-designed controlled studies without randomization. The majority of papers were non-experimental clinical descriptive studies or case series. Data from this review would suggest that more comprehensive evidence-based studies are required in order to settle areas of confusion surrounding treatment of this relapsing condition