UNASSIGNED: Persistent postural-perceptual dizziness (PPPD) is a chronic vestibular syndrome often triggered by acute or episodic vestibular syndromes, such as Meniere\'s disease (MD). According to the diagnostic criteria, PPPD may coexist with other structural diseases, and the evidence of another active illness does not necessarily exclude PPPD diagnosis. However, persistent symptoms, even those meeting the PPPD criteria even long after Meniere\'s attack, are often overlooked as potential PPPD precipitated by MD. Some clinicians overlook PPPD in such patients, treating them solely for MD once diagnosed. Since a treatment strategy for PPPD is completely different from that for MD, this may result in the deprivation of adequate treatments.
UNASSIGNED: To emphasize the importance of diagnosing PPPD coexisting with MD including not treating such patients solely for MD, and to compare the clinical features of PPPD and MD.
UNASSIGNED: Vestibular function tests, including canal paresis (CP)%, c- and o-vestibular myogenic potentials, vestibulo-ocular reflex-direction preponderance, and posturography and clinical symptom scales, including the Dizziness Handicap Inventory, Niigata PPPD Questionnaire, and Hospital Anxiety and Depression Scale, were compared between 105 PPPD patients with MD or other precipitants and 130 patients with MD alone. The clinical symptom scales were further compared between 23 patients with PPPD coexisting with MD and those with MD alone.
UNASSIGNED: The CP% was significantly higher in patients with MD than in those with PPPD. However, the total and subscores of all three clinical symptom scales were higher in patients with PPPD than in those with MD. The total score on all clinical symptom scales was higher in patients with PPPD coexisting with MD than in those with MD alone.
UNASSIGNED: Persistent postural-perceptual dizziness development from a precipitating MD may be associated with more severe clinical symptoms. Thus, clinical symptom scales may be useful for detecting PPPD in patients with Meniere\'s disease.

OBJECTIVE: Both vestibular neuronitis (VN) and Meniere\'s disease (MD) have great impact on quality of life and are associated with a significant number of sick leave days absent from work. The aim was to assess labor market participation rate one year after hospital diagnosis of VN and MD and the use of rehabilitation measures.
METHODS: Nationwide register-based cohort study including patients with VN (n = 1,341) and MD (n = 843) and control persons matched in 1:5 with a VN cohort control (n = 6,683) and MD cohort control (n = 4,209).
RESULTS: Compared to control persons, VN patients were more likely to be single, have higher income, and a higher Charlson comorbidity index score. MD patients had a higher level of education and a higher Charlson index compared to control persons. One year after patients were diagnosed with VN, no significant difference in labor market participation was observed (p = 0.88). However, MD patients had a 10.4% reduced probability of possessing a full-time job one year after diagnosis compared to matched control persons (58.1 ± 0.5% vs. 68.5 ± 0.5%, p < 0.001). Both VN and MD patients consulted otorhinolaryngologists, general practitioners, and physiotherapists more than control persons both before and after the initial diagnosis (p < 0.01). In addition, MD patients also consulted psychologists more frequently before and after diagnosis of the disease (p < 0.01).
CONCLUSIONS: Intrahospital diagnosed MD increases the risk of leaving the labor market in opposition to VN. Both MD and VN are associated with significant expenses to the Danish health care system from the use of public rehabilitation measures and medical consultations.

UNASSIGNED: Many studies have discussed the betahistine treatment for Meniere\'s disease (MD). However, regarding cochlear MD, there is no consensus on the long-term betahistine treatment.
UNASSIGNED: This study aims to investigate the relationship between the betahistine treatment duration in patients with cochlear MD and their clinical outcomes.
UNASSIGNED: We enrolled 78 patients with 96 ears who were diagnosed with cochlear MD and received the treatment for more than 6 months. Outcomes included the hearing status, frequency of acute hearing loss attack, and whether the disease progressed to MD. Clinical characteristics including age, sex, side of affected ear, treatment duration of betahistine and trichlormethiazide, and pre-treatment hearing level was recorded from medical charts.
UNASSIGNED: Comparing the clinical characteristics by outcomes, the average betahistine treatment duration was the independent factor for hearing status of four-tone average (p = 0.01) and low-tone average (p = 0.03). Patients with average betahistine treatment duration of at least 277 days per year had higher odds ratio for improvement of the hearing status of four-tone and low-tone average.
UNASSIGNED: For patients with cochlear MD, regular and long-term betahistine treatment can benefit their hearing outcome in the low- and medium-frequency.

Objectives: The aim of this study was to evaluate the functional outcomes and balance compensation in patients with severe Meniere\'s disease after vestibular neurectomy. Methods: Pre- and postoperative results were analyzed in twenty patients with unilateral Meniere\'s disease before and two years after vestibular neurectomy. Clinical evaluation was performed using a subjective grading scale proposed by the American Academy of Otolaryngology-Head and Neck Surgery and the Dizziness Handicap Inventory. Sensory organization test results were analyzed to assess the balance system before and after the surgery. Results: All patients reported a complete resolution of vertigo attacks after the vestibular neurectomy; 95% of patients reported functional level improvement according to a scale proposed by the American Academy of Otolaryngology-Head and Neck Surgery, and the average score decreased from 4.5 to 1.6. Clinical improvement, evaluated with the Dizziness Handicap Inventory, was present in all patients, with the average result decreasing from 81.7 to 16.4. Analyzing both grading systems, differences between pre- and postoperative results were statistically significant. No statistically significant differences were found between the sensory organization test results before and after vestibular neurectomy. Significant correlations were found between a patient\'s age and postoperative results of the Dizziness Handicap Inventory and posturography. Conclusions: Vestibular neurectomy is an effective vertigo treatment in patients with severe Meniere\'s disease with no clinical improvement despite conservative treatment. It results in subjective physical, functional, and emotional improvement, enabling patients to return to daily activities and work. An appropriate qualification of patients and comprehensive preoperative evaluation are essential to obtaining satisfactory clinical outcomes.

Characterising inner ear disorders represents a significant challenge due to a lack of reliable experimental procedures and identified biomarkers. It is also difficult to access the complex microenvironments of the inner ear and investigate specific pathological indicators through conventional techniques. Omics technologies have the potential to play a vital role in revolutionising the diagnosis of ear disorders by providing a comprehensive understanding of biological systems at various molecular levels. These approaches reveal valuable information about biomolecular signatures within the cochlear tissue or fluids such as the perilymphatic and endolymphatic fluid. Proteomics identifies changes in protein abundance, while metabolomics explores metabolic products and pathways, aiding the characterisation and early diagnosis of diseases. Although there are different methods for identifying and quantifying biomolecules, mass spectrometry, as part of proteomics and metabolomics analysis, could be utilised as an effective instrument for understanding different inner ear disorders. This study aims to review the literature on the application of proteomic and metabolomic approaches by specifically focusing on Meniere\'s disease, ototoxicity, noise-induced hearing loss, and vestibular schwannoma. Determining potential protein and metabolite biomarkers may be helpful for the diagnosis and treatment of inner ear problems.

UNASSIGNED: Although various medical remedies have been attempted to alleviate the symptoms of Meniere\'s disease (MD), the risk-benefit ratios of these various treatments remain debatable.
UNASSIGNED: We investigated the efficacy of sound stimulation of 100 Hz for treating vestibular dysfunction in patients with Meniere\'s disease (MD).
UNASSIGNED: Patients with definitive MD with intractable vestibular symptoms and endolymphatic hydrops (EH) in the inner ear were evaluated. The experimental group received sound stimulation of 75 dB at a frequency of 100 Hz for 5 min, and the control group received sound stimulation of 75 dB at a frequency of 250 Hz for 5 min. Cervical vestibular-evoked myogenic potentials (cVEMPs) were measured before and after each sound stimulation, and the results of the clinical tests were compared between the two patient groups.
UNASSIGNED: Significant increases in cVEMP amplitudes were observed after sound stimulation of 100 Hz in ears with vestibular endolymphatic hydrops, although no such improvement was observed in the control group.
UNASSIGNED: Sound stimulation of 75 dB at a frequency of 100 Hz leads to improvement in cVEMP amplitude in patients with definitive MD. Adequate sound stimulation might be a new method for treating vestibular dysfunction associated with MD.

Objective: Evaluation of the effectiveness and posttreatment effects of intratympanic gentamicin and corticosteroids in treating patients with Ménière\'s disease (MD). Methods: Based on PubMed and Embase databases, randomized controlled trials using intratympanic injections of 4 drugs (gentamicin, methylprednisolone, dexamethasone, and placebo) for the treatment of MD were searched from 1995 to October 2023, and the literature was screened according to inclusion and exclusion criteria, and data were netted for meta-analysis using Stata 17. Results: A total of 13 studies were selected, involving 559 participants, with follow-up time ranging from 3 to 28 months. Meta-analysis showed that there was no statistically significant difference in pure-tone average between gentamicin and dexamethasone [standardized mean difference (SMD) = 0.09, 95% confidence interval (CI) (-0.42, 0.24), P < .05]. Compared to placebo, intratympanic injection of gentamicin [risk ratio (RR) = 1.18, 95% CI (0.43, 1.93)], methylprednisolone [RR = 0.88, 95% CI (0.07, 1.70)], and dexamethasone [RR = 0.70, 95% CI (-0.01, 1.41)] all showed better efficacy in treating vertigo. For the treatment of tinnitus, the SUCRA ranking results showed that dexamethasone was the most effective, followed by methylprednisolone and gentamicin. Conclusion: Pharmacological intervention is more effective than placebo in treating MD. Although gentamicin treatment shows significant effects in treating vertigo, corticosteroid combination therapy is markedly superior to gentamicin in controlling hearing loss and vertigo symptoms.

BACKGROUND: Diagnostic dilemma between clinical Meniere\'s disease and radiological endolymphatic hydrops (EH) has emerged since the introduction of hydrops magnetic resonance imaging (MRI). The aim of this study is to explore the potential application of hydrops MRI on diagnosing the EH.
METHODS: This review was developed from peer-reviewed articles published in those journals listed on journal of citation reports. The MEDLINE database of the US National Library of Medicine, Scopus, and Google Scholar were used to collect articles based on the guidelines (PRISMA 2020 statement) for reporting reviews.
RESULTS: Initially, 470 articles were retrieved from 1983 to 2023, and 80 relevant articles were ultimately selected. The sensitivity (69%-92%) and specificity (78%-96%) values varied from each laboratory for detecting EH via hydrops MRI, probably due to candidate selection and the grading system employed.
CONCLUSIONS: The application of hydrops MRI allows (1) differentiation between EH and sudden sensorineural hearing loss; (2) determination of the affected side of EH; and (3) confirmation of the diagnosis of EH concomitant with other disorders. Notably, not all differentials for EH can be visualized on MR images. One of the existing gaps to be filled is that updated hydrops MRI fails to identify distortion, that is, rupture, collapse, fistula, or fibrosis of the inner ear compartments, akin to what histopathological evidence can demonstrate. Hence, enhanced ultrahigh resolution of hydrops MRI is required for demonstrating fine structures of the inner ear compartments in the future.

UNASSIGNED: According to observational research, migraine may increase the risk of Meniere\'s disease (MD). The two have not, however, been proven to be causally related.
UNASSIGNED: Using Mendelian random (MR) analysis, we aimed to evaluate any potential causal relationship between migraine and MD. We extracted single-nucleotide polymorphisms (SNPs) from large-scale genome-wide association studies (GWAS) involving European individuals, focusing on migraine and MD. The main technique used to evaluate effect estimates was inverse-variance weighting (IVW). To assess heterogeneity and pleiotropy, sensitivity analyses were carried out using weighted median, MR-Egger, simple mode, weighted mode, and MR-PRESSO.
UNASSIGNED: There was no discernible causative link between genetic vulnerability to MD and migraine. The migraine dose not increase the prevalence of MD in the random-effects IVW method (OR = 0.551, P = 0.825). The extra weighted median analysis (OR = 0.674, P = 0.909), MR-Egger (OR = 0.068, P = 0.806), Simple mode (OR = 0.170, P = 0.737), and Weighted mode (OR = 0.219, P= 0.760) all showed largely consistent results. The MD dose not increase the prevalence of migraine in the random-effects IVW method (OR = 0.999, P = 0.020). The extra weighted median analysis (OR = 0.999, P = 0.909), MR-Egger (OR = 0.999, P = 0.806), Simple mode (OR = 0.999, P = 0.737), and Weighted mode (OR = 1.000, P = 0.760).
UNASSIGNED: This Mendelian randomization study provides casual evidence that migraine is not a risk factor for MD and MD is also not a risk factor for migraine.

UNASSIGNED: This study aimed to explore and visualize the relationships among multiple symptoms in patients with Meniere\'s disease (MD) and aid clinical nurses in the design of accurate, individualized interventions.
UNASSIGNED: This study included 790 patients with MD at the Eye and ENT Hospital of Fudan University from October 2014 to December 2021. A self-designed symptom checklist was used to assess 15 MD-related symptoms and construct contemporaneous networks with all 15 symptoms in R software. Qgraph package and Fruchterman-Reingold layout were used for network visualization. Bootstrapping methods were performed to assess network accuracy and stability, and three centrality indices were adopted to describe relationships among symptoms.
UNASSIGNED: Symptom networks showed good accuracy and stability. \"Anxiety and nervousness\"(98.2%), \"aural fullness\"(84.4%) and \"tinnitus\"(82.7%) were the common symptom in MD patients, while \"tinnitus\", \"aural fullness\" and \"decline in word recognition\", were more serious. MD patients with longer disease duration had higher prevalence and severity for all symptoms (P < 0.05). Symptom networks showed good accuracy and stability. \"Decline in word recognition,\" \"fatigue,\" and \"anxiety and nervousness\" were at the center of the symptom networks, which had the largest strength values and closeness. \"Decline in word recognition,\" \"headache,\" and \"spatial discrimination and poor orientation\" were the symptoms with the highest betweenness with the strongest bridging effect. The ≥1-year disease group exhibited higher centralities for \"drop attack\" and \"anxiety and nervousness,\" and a lower centrality for \"headache\" compared with the <1-year disease group.
UNASSIGNED: The symptom networks of MD patients with varying disease durations were revealed. Clinicians and nurses must provide precision interventions tailored to modifying symptom severity and centrality. Nursing interventions should focus on word recognition issues and associated discomfort in MD patients with multiple symptoms.