Meniere Disease (Idiopathic Endolymphatic Hydrops) Questions & Answers

Updated: Jun 08, 2018
  • Author: John C Li, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Questions & Answers

Overview

What is Ménière disease (idiopathic endolymphatic hydrops)?

What is the difference between Ménière disease (idiopathic endolymphatic hydrops) and Ménière syndrome?

Why is evaluation and management of Ménière disease (idiopathic endolymphatic hydrops) challenging?

How is medical therapy directed in Ménière disease (idiopathic endolymphatic hydrops)?

What anatomy is relevant to Ménière disease (idiopathic endolymphatic hydrops)?

What is the anatomy of the cochlear-vestibular apparatus relevant to Ménière disease (idiopathic endolymphatic hydrops)?

What is the anatomy of the vestibular system relevant to Ménière disease (idiopathic endolymphatic hydrops)?

What is the joint anatomy of the cochlea and vestibular system relevant to Ménière disease (idiopathic endolymphatic hydrops)?

How might the anatomy of the vestibular system be visualized in Ménière disease (idiopathic endolymphatic hydrops)?

What is the anatomy of the endolymphatic sac relevant to Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of endolymphatic flow in the etiology of Ménière disease (idiopathic endolymphatic hydrops)?

What is the pathophysiology of Ménière disease (idiopathic endolymphatic hydrops)?

What causes hydrops attacks in Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of endolymphatic pressure in the pathogenesis of Ménière disease (idiopathic endolymphatic hydrops)?

Which extrinsic mechanisms are thought to contribute to the pathogenesis of Ménière disease (idiopathic endolymphatic hydrops)?

What causes Ménière disease (idiopathic endolymphatic hydrops)?

Which disorders that give rise to elevated endolymphatic pressure should be differentiated from Ménière disease (idiopathic endolymphatic hydrops)?

What is a possible autoimmune etiology of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of allergens in the etiology of Ménière disease (idiopathic endolymphatic hydrops)?

How does the incidence of Ménière disease (idiopathic endolymphatic hydrops) vary by age?

How does the prevalence of Ménière disease (idiopathic endolymphatic hydrops) vary by sex?

What is the prevalence of Ménière disease (idiopathic endolymphatic hydrops) in the US?

Why does the prevalence of Ménière disease (idiopathic endolymphatic hydrops) vary among geographic locations?

What is the mortality rate for Ménière disease (idiopathic endolymphatic hydrops)?

What is the progression of Ménière disease (idiopathic endolymphatic hydrops)?

What is the prognosis of Ménière disease (idiopathic endolymphatic hydrops)?

What is the spontaneous remission rate for Ménière disease (idiopathic endolymphatic hydrops)?

What is the main morbidity associated with Ménière disease (idiopathic endolymphatic hydrops)?

What is included in the patient education information for Ménière disease (idiopathic endolymphatic hydrops)?

Presentation

How does the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNS) Committee define Ménière disease (idiopathic endolymphatic hydrops)?

What history is characteristic of Ménière disease (idiopathic endolymphatic hydrops)?

How is vertigo characterized in Ménière disease (idiopathic endolymphatic hydrops)?

How does acute vertigo manifest in Ménière disease (idiopathic endolymphatic hydrops)?

How does hearing loss manifest in Ménière disease (idiopathic endolymphatic hydrops)?

How is tinnitus characterized in Ménière disease (idiopathic endolymphatic hydrops)?

Which physical findings are characteristic of Ménière disease (idiopathic endolymphatic hydrops) vary?

What are physical findings suggestive of a Ménière disease (idiopathic endolymphatic hydrops) attack?

What are the otoscopy findings characteristic of Ménière disease (idiopathic endolymphatic hydrops)?

Why is a complete neurologic exam necessary for evaluation of suspected Ménière disease (idiopathic endolymphatic hydrops)?

Which test is used to evaluate vertigo in suspected Ménière disease (idiopathic endolymphatic hydrops)?

How is the Dix-Hallpike positional test performed in suspected Ménière disease (idiopathic endolymphatic hydrops)?

Which Dix-Hallpike positional test findings suggest Ménière disease (idiopathic endolymphatic hydrops)?

What is the purpose of the Romberg test in the evaluation of suspected Ménière disease (idiopathic endolymphatic hydrops)?

What is the significance of the Hennebert sign in the evaluation of suspected Ménière disease (idiopathic endolymphatic hydrops)?

What is the significance of the Tullio phenomenon in the evaluation of Ménière disease (idiopathic endolymphatic hydrops)?

How is the gross evaluation of hearing performed in suspected Ménière disease (idiopathic endolymphatic hydrops)?

How is the Rinne test performed in the evaluation of hearing loss Ménière disease (idiopathic endolymphatic hydrops)?

How is the Weber test performed in the evaluation of Ménière disease (idiopathic endolymphatic hydrops)?

Which test of hearing loss is most accurate in the evaluation of Ménière disease (idiopathic endolymphatic hydrops)?

What are the complications of Ménière disease (idiopathic endolymphatic hydrops)?

DDX

What do the American Academy of Otolaryngology (AAO) guidelines require for the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

Which other conditions should be considered in the differential diagnoses of Ménière disease (idiopathic endolymphatic hydrops)?

What are the differential diagnoses for Meniere Disease (Idiopathic Endolymphatic Hydrops)?

Workup

What is the role of lab tests in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of imaging studies in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

Which lab studies may be ordered to exclude obvious metabolic disturbances, infections, or hormonal imbalances during the evaluation for Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of MRI and CT in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

When is MRI of the brain indicated in the evaluation of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of 3-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI) in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

How is CT scanning used in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of audiometry in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of electrocochleography (ECOG) in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

How is an electronystagmography (ENG) test used in the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

How is a patient prepared for electronystagmography (ENG) to test for Ménière disease (idiopathic endolymphatic hydrops)?

How is the caloric portion of the electronystagmography (ENG) test performed for the diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

Which results on electronystagmography (ENG) suggest endolymphatic hydrops in Ménière disease (idiopathic endolymphatic hydrops)?

Which results on electronystagmography (ENG) suggest nystagmus in Ménière disease (idiopathic endolymphatic hydrops)?

Treatment

How is medical therapy for Ménière disease (idiopathic endolymphatic hydrops) directed?

When is inpatient care indicated for Ménière disease (idiopathic endolymphatic hydrops)?

What is the first-line management for Ménière disease (idiopathic endolymphatic hydrops)?

When is surgical therapy indicated for Ménière disease (idiopathic endolymphatic hydrops)?

What is included in follow-up of patients diagnosed with Ménière disease (idiopathic endolymphatic hydrops)?

What is the goal of medical treatment for Ménière disease (idiopathic endolymphatic hydrops)?

Which medications are used to treat Ménière disease (idiopathic endolymphatic hydrops)?

What is the initial treatment for Ménière disease (idiopathic endolymphatic hydrops)?

Which medications are used to mask the symptoms of vertigo in Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of diuretic and diuretics-like medications in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of steroids in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of aminoglycosides in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How are aminoglycosides administered for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of histamine agonists in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How is the Meniett device used in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

When is surgery indicated in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the rationale for destruction of the inner ear, the vestibular nerve, or both in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

When is destruction of the inner ear, the vestibular nerve, or both contraindicated in Ménière disease (idiopathic endolymphatic hydrops)?

What are the nondestructive surgical options for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the endolymphatic sac procedure for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the prognosis of Ménière disease (idiopathic endolymphatic hydrops) following treatment with the endolymphatic sac procedure?

Why is the endolymphatic sac procedure considered a controversial treatment for Ménière disease (idiopathic endolymphatic hydrops)?

How is endolymphatic sac procedure performed for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How is the endolymphatic sac distinguished from dura in the surgical treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How is the endolymphatic sac procedure terminated in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the effectiveness of endolymphatic sac surgery for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of vestibular nerve sectioning in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How is sectioning of the vestibular nerve performed for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the retrosigmoid approach to vestibular nerve sectioning in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How is the vestibular nerve distinguished from other nerves in the surgical treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the middle fossa approach to vestibular nerve sectioning for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the advantage of the middle fossa approach to vestibular nerve sectioning for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What are the disadvantages of the middle fossa approach to vestibular nerve sectioning for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What are the benefits of vestibular nerve sectioning for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is included in the postoperative care following vestibular nerve sectioning for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of labyrinthectomy in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is included in the postoperative care following labyrinthectomy for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the transcanal approach to labyrinthectomy for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the basic mastoidectomy approach to labyrinthectomy for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of cochlear implant in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

When was transtympanic perfusion of medication first developed for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

How are medications applied in transtympanic perfusion for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of transtympanic steroid application for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of transtympanic aminoglycoside application for the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of vestibular rehabilitation in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

What is the role of dietary modifications in the management of Ménière disease (idiopathic endolymphatic hydrops)?

Which dietary restrictions are beneficial in the management of Ménière disease (idiopathic endolymphatic hydrops)?

Which activity restrictions are needed in the management of Ménière disease (idiopathic endolymphatic hydrops)?

How is Ménière disease (idiopathic endolymphatic hydrops) prevented with dietary restrictions?

What should be avoided to prevent Ménière disease (idiopathic endolymphatic hydrops)?

Which specialist consultation may be helpful in diagnosis of Ménière disease (idiopathic endolymphatic hydrops)?

Why should multispecialty consultations be limited in Ménière disease (idiopathic endolymphatic hydrops)?

Which specialist is most suited to manage patients with Ménière disease (idiopathic endolymphatic hydrops)?

Medications

What are the goals of drug treatment for Ménière disease (idiopathic endolymphatic hydrops)?

Which medications are used for vertiginous symptoms of Ménière disease (idiopathic endolymphatic hydrops)?

Which medications are used in the treatment of Ménière disease (idiopathic endolymphatic hydrops)?

Which medications in the drug class Adrenergic Agonists are used in the treatment of Meniere Disease (Idiopathic Endolymphatic Hydrops)?

Which medications in the drug class Diuretics are used in the treatment of Meniere Disease (Idiopathic Endolymphatic Hydrops)?

Which medications in the drug class Corticosteroids are used in the treatment of Meniere Disease (Idiopathic Endolymphatic Hydrops)?

Which medications in the drug class Vestibulosuppressants are used in the treatment of Meniere Disease (Idiopathic Endolymphatic Hydrops)?