Evaluation of a large cohort of adult patients with Ménière’s disease: bedside and clinical history

Teggi, Roberto; Battista, Rosa Alessia; Berardino, Federica Di; Familiari, Marco; Cangiano, Iacopo; Gatti, Omar; Bussi, Mario

doi:10.14639/0392-100x-n0776

Cited by 17 publications

(24 citation statements)

References 30 publications

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“…In larger series of non-operated MD, it was demonstrated that SVIN may be observed in 59% to 66% of cases [ 24 , 25 ] and usually shows a low SPV < 4°/s (3.89 ± 3.9°/s) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

et al. 2021

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Background/Aim: the aim of this study was to assess the skull vibration-induced nystagmus test (SVINT) results and vestibular residual function after horizontal semicircular canal (HSCC) plugging. Methods: In this retrospective chart review performed in a tertiary referral center, 11 patients who underwent unilateral horizontal semicircular canal plugging (uHSCCP) for disabling Menière’s disease (MD) were included. The skull vibration-induced nystagmus (SVIN) slow-phase velocity (SPV) was compared with the results of the caloric test (CaT), video head impulse test (VHIT), and cervical vestibular-evoked myogenic potentials (cVEMP) performed on the same day. Results: Overall, 10 patients had a strong SVIN beating toward the intact side (Horizontal SVIN-SPV: 8.8°/s ± 5.6°/s), 10 had a significant or severe ipsilateral CaT hypofunction, 10 had an ipsilateral horizontal VHIT gain impairment, and 3 had altered cVEMP on the operated side. Five had sensorineural hearing worsening. SVIN-positive results were correlated with CaT and horizontal VHIT (HVHIT) results (p < 0.05) but not with cVEMP. SVIN-SPV was correlated with CaT hypofunction in % (p < 0.05). Comparison of pre- and postoperative CaT % hypofunction showed a significant worsening (p = 0.028). Conclusion: SVINT results in a human model of horizontal canal plugging are well correlated with vestibular tests exploring horizontal canal function, but not with cVEMP. SVINT always showed a strong lesional nystagmus beating away from the lesion side. SVIN acts as a good marker of HSCC function. This surgical technique showed invasiveness regarding horizontal canal vestibular function.

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“…In larger series of non-operated MD, it was demonstrated that SVIN may be observed in 59% to 66% of cases [ 24 , 25 ] and usually shows a low SPV < 4°/s (3.89 ± 3.9°/s) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

et al. 2021

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“…Additionally, patients may experience a myriad of symptoms consisting of (but not limited to) tinnitus, aural fullness, or a sudden fall without loss of consciousness known as drop attacks (14)(15)(16). Migraine and autoimmune diseases are common comorbidities, reported in up to 16 and 11% of patients respectively (17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

et al. 2021

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Research Objective: To investigate the correlation between clinical features and MRI-confirmed endolymphatic hydrops (EH) and blood-labyrinth barrier (BLB) impairment.Study Design: Retrospective cross-sectional study.Setting: Vertigo referral center (Haga Teaching Hospital, The Hague, the Netherlands).Methods: We retrospectively analyzed all patients that underwent 4 h-delayed Gd-enhanced 3D FLAIR MRI at our institution from February 2017 to March 2019. Perilymphatic enhancement and the degree of cochlear and vestibular hydrops were assessed. The signal intensity ratio (SIR) was calculated by region of interest analysis. Correlations between MRI findings and clinical features were evaluated.Results: Two hundred and fifteen patients with MRI-proven endolymphatic hydrops (EH) were included (179 unilateral, 36 bilateral) with a mean age of 55.9 yrs and median disease duration of 4.3 yrs. Hydrops grade is significantly correlated with disease duration (P < 0.001), the severity of low- and high-frequency hearing loss (both P < 0.001), and the incidence of drop attacks (P = 0.001). Visually increased perilymphatic enhancement was present in 157 (87.7%) subjects with unilateral EH. SIR increases in correlation with hydrops grade (P < 0.001), but is not significantly correlated with the low or high Fletcher index (P = 0.344 and P = 0.178 respectively). No significant differences were found between the degree of EH or BLB impairment and vertigo, tinnitus or aural fullness.Conclusion: The degree of EH positively correlates with disease duration, hearing loss and the incidence of drop attacks. The BLB is impaired in association with EH grade, but without clear contribution to the severity of audiovestibular symptoms.

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“…Migraine vertigo (MV) and Ménière's disease (MD) share several signs and symptoms such as tinnitus, fullness, photophobia, phonophobia, headache and vertigo spells lasting hours 1,2 . Diagnosis of MD or MV is based on anamnes-tic data and clinical features, making differential diagnosis very difficult 3 .…”

Section: Introductionmentioning

confidence: 99%

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

Immordino

Priola

Salvago

et al. 2021

Acta Otorhinolaryngol Ital

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Introduction. Migraine vertigo (MV) and Ménière's disease (MD) share several signs and symptoms such as tinnitus, fullness, photophobia, phonophobia, headache and vertigo spells lasting hours. Objective. The aim of the present study was to prospectively observe patients with MV with a sporadic audiological symptom evaluated with clinical examination, Vestibular Evoked Myogenic Potentials (VEMPs), ECochG and v-HIT. Results. The finding of VEMP asymmetry, according to our cut-off of 33% of difference between sides, resulted in 20 cases, of which 6 had asymmetry of both c-VEMPs and o-VEMPS, all with development of fluctuating hearing during follow-up. ECochG was positive for endolymphatic hydrops in 12 patients. Conclusions. The evolution of MV may have a variable course in which some patients may develop symptoms typical of MD. The two diseases may be contextually present at the same time configuring an overlapping syndrome, and asymmetric VEMPs might predict development of fluctuating hearing.

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Evaluation of a large cohort of adult patients with Ménière’s disease: bedside and clinical history

Cited by 17 publications

References 30 publications

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

Hydropic Ear Disease: Correlation Between Audiovestibular Symptoms, Endolymphatic Hydrops and Blood-Labyrinth Barrier Impairment

Evolution of migraine vertigo in overlapping syndrome with Ménière’s disease: prognostic role of instrumental examination

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