Materiały źródłowe

• #1 What Is Ménière’s Disease? — Diagnosis and Treatment

  https://www.nidcd.nih.gov/health/menieres-disease

  How is Mnires disease diagnosed? […] Mnires disease is most often diagnosed and treated by an otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT). There is no definitive test or single symptom that a doctor can use to make a diagnosis. Your doctor may suggest a hearing screening to identify any hearing loss. To rule out other diseases, magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain may be recommended. […] A diagnosis of definite Mnires disease is based on your medical history and on the presence of: […] Two or more spontaneous episodes of vertigo lasting 20 minutes to 12 hours. […] Hearing loss in one or both ears for low to medium frequency sounds, documented by a hearing test before, during, or after one of the episodes of vertigo.

• #1 Classifications of Meniere’s Disease – American Academy of Audiology

  https://www.audiology.org/classifications-of-menieres-disease/

  The diagnostic criteria for MD was revised in 2015 through a joint effort of the Classification Committee of the Brny Society, The Japanese Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and the Korean Balance Society. […] They describe two classifications, Definite MD and Probable MD. According to the new diagnostic consensus statement: […] Definite Menieres must meet the following criteria: Two or more spontaneous episodes of vertigo each lasting 20 minutes to 12 hours; Audiometrically documented low- to medium frequency sensorineural hearing loss in one ear, defining the affected ear on at least one occasion before, during or after one of the episodes of vertigo; Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear; Not better accounted for by another vestibular diagnosis. […] Probable MD must meet the following criteria: Two or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours; Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear; Not better accounted for by another vestibular diagnosis.

• #1 Meniere Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536955/

  Meniere disease is an inner ear disorder characterized by tinnitus, vertigo, and hearing loss. […] The current diagnostic criteria defined by the Barany society by Lopez-Escamez, et al. can help differentiate between probable and definite Meniere’s disease. […] Patients with a definite Meniere disease, according to the Barany Society, have: Two or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours; Audiometrically documented low- to medium-frequency sensorineural hearing loss in one ear, defining and locating to the affected ear on in at least one instance prior, during, or after one of the episodes of vertigo; Fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear; Not better accounted for by any other vestibular diagnosis. […] Probable Meniere disease can include the following clinical findings: Two or more episodes of dizziness or vertigo, each lasting 20 minutes to 24 hours; Fluctuating aural symptoms (fullness, hearing, or tinnitus) in the affected ear; The condition is better explained by another vestibular diagnosis.

• #1 Meniere’s Disease: Diagnosis and Management   – PcMED Project

  https://pcmedproject.com/ent/menieres-disease-diagnosis-and-management/

  The diagnostic criteria for definite MD include two or more spontaneous attacks of vertigo, each lasting 20 minutes to 12 hours, audiometrically documented fluctuating low- to midfrequency sensorineural hearing loss in the affected ear on at least 1 occasion, fluctuating aural symptoms in the affected ear, and other causes excluded by other tests. […] The diagnostic criteria for probable MD include two or more episodes of vertigo OR dizziness, each lasting 20 minutes to 24 hours, fluctuating aural symptoms in the affected ear, and other causes excluded by other tests.

• #1 What Is Ménière’s Disease? — Diagnosis and Treatment

  https://www.nidcd.nih.gov/health/menieres-disease

  Hearing-related symptoms that occur irregularly, e.g., tinnitus, hearing loss, or a feeling of fullness in the affected ear. […] Symptoms not accounted for by another diagnosed balance-related condition. […] Probable Mnires disease is typically diagnosed when you have all the symptoms listed above except hearing loss confirmed by a hearing test before, during, or after an episode of vertigo. […] Insights into the mechanisms in the inner ear that trigger symptoms of Mnires disease will guide scientists as they develop preventive strategies and more effective treatment. NIDCD is supporting scientific research that seeks to: […] Improve our ability to diagnose balance disorders by developing new tests, including: […] Using new measurements to assess how much motion a person can perceive instead of the standard assessment of balance reflexes, which often provides inconclusive or negative results. […] A technique called auditory nerve overlapped waveform, which is being used to detect symptoms in the earliest stages of Mnires disease, before the disease progresses and can be detected with conventional measures.

• #1 Meniere’s Disease: Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15167-menieres-disease

  Otolaryngologists (ENTs) diagnose Mnires disease. During your visit, your provider will perform a physical exam and neurological exam and ask about your symptoms. They may ask if you have regular episodes of vertigo and hearing loss. If you do, theyll ask about how severe they are and how long they last. […] They may do tests to rule out other potential conditions to confirm you have Mnires disease, including: […] Hearing test: The test will show if youve experienced hearing loss. During this test, a hearing specialist called an audiologist plays sounds through headphones. Youll press a button when you hear a sound. […] Vestibular test battery: Audiologists perform a series of tests to check the reflex of your inner ear (vestibular) balance system and eye muscles. Although your balance mostly returns to normal when youre not experiencing a vertigo attack, there may be leftover effects the tests can detect.

• #1 Meniere disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/meniere-disease/

  Meniere disease is diagnosed based on the characteristic clinical features and demonstrable low- to mid-frequency SNHL on audiometry. Specialized tests (e.g., vestibular function testing, electrocochleography) are reserved for patients with atypical symptoms or before attempting ablative therapies. Neuroimaging should be considered if central vertigo is suspected. […] Diagnostic criteria for Meniere disease: must include all of the following criteria: 2 spontaneous attacks of vertigo, each lasting 20 min to 12 hrs; Low to mid-frequency sensorineural hearing loss in the affected ear on audiometry; Fluctuating aural symptoms in the affected ear (hearing loss, tinnitus, or ear fullness); Other suspected causes of vertigo excluded. […] Subjective audiometry should always be performed in both ears. Pure-tone audiometry: low- to mid-frequency sensorineural hearing loss (SNHL), with 15 dB difference between the two ears; Speech audiometry (with word recognition score): a difference of 15% in word recognition score between the two ears.

• #1 Meniere’s disease – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/155

  Meniere’s disease (MD) is an episodic auditory and vestibular disease characterised by sudden onset of vertigo, hearing loss, tinnitus, and sensation of fullness in the affected ear. […] Diagnosis is made on clinical history and detailed audiological tests; other investigations may be required to exclude other causes. […] Key diagnostic factors include presence of risk factors, vertigo, hearing loss, tinnitus, aural fullness, and drop attacks. […] 1st investigations to order include pure-tone air and bone conduction with masking, speech audiometry, tympanometry/immittance/stapedial reflex levels, and oto-acoustic emissions (OAE). […] Investigations to consider include electrocochleography, electronystagmography, rotary chair test, vestibular-evoked myogenic potential (VEMP), MRI of internal auditory canals, thyroid function tests, Lyme disease and syphilis serology, anti-nuclear antibody, anti-neutrophil cytoplasmic antibody, and rheumatoid factor. […] Emerging tests include 3-dimensional MRI.

• #1 Meniere’s Disease

  http://www.earcentergreensboro.com/medical-education/menieres_disease.php

  Evaluation of the inner ear balance system and its connections to the central nervous system are done by a test called „electronystagmography” (ENG). […] A new test, vestibular evoked myopotentials, VEMP, are now being used to test patients who are suspected of having Meniere’s Disease. […] The hearing nerve and hearing pathways within the brain can be measured by a special computerized test called an „Auditory Brainstem Response Test” or ABR. […] Several tests of inner ear function are available. One test called „Otoacoustic Emissions” or OAE is performed to evaluate the health of tiny inner ear hair cells (the outer hair cells). […] An image of the brain and hearing/balance nerves can be made by performing a brain scan called a „Magnetic Resonance Imaging” (MRI) Scan. […] Measurements of hemoglobin, blood sugar (glucose), cholesterol, immune system status, liver, kidney, thyroid function testing, and testing for infectious diseases such as syphilis, lyme disease, and infectious mononucleosis may be among the studies needed to rule out other conditions that may cause symptoms similar to those found in Meniere’s disease. […] There is no single study that diagnoses Meniere’s disease with absolute certainty. Ultimately, the patient and a skilled ear specialist must evaluate the history, physical examinations, entire clinical picture, and test results together in order to arrive at a diagnosis.

• #1 Meniere’s Disease ENT Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/dizziness-balance/menieres-disease/

  Mnires disease, also called idiopathic endolymphatic hydrops, is a disorder of the inner ear. […] Your physician will take a history of the frequency, duration, severity, and character of your attacks, the duration of hearing loss or whether it has been changing, and whether you have had tinnitus or fullness in either or both ears. Tests may be ordered to look for these problems in certain cases. When the history has been completed, diagnostic tests will check your hearing and balance functions. […] An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patients ability to distinguish words) is often diminished in the affected ear. […] A VNG (videonystagmograph) may be performed to evaluate balance function. In a darkened room, recording electrodes are placed near the eyes. Warm and cool water or air are gently introduced into each ear canal. Since the eyes and ears work in coordination through the nervous system, measurement of eye movements can be used to test the balance system. In many patients, the balance function is reduced in the affected ear.

• #1 Understanding Meniere’s Disease: Symptoms, Diagnosis, and Treatment Options – THANC Hospital

  https://thanchospital.com/understanding-menieres-disease-symptoms-diagnosis-treatment-options/

  DIAGNOSIS : […] A hearing test is called audiometry. Audiometry looks at how well you hear sounds at different pitches and volumes. It can also test how well you can tell between words that sound the same. People with Menieres disease often have trouble hearing low frequencies or combined high and low frequencies. They may have typical hearing in the midrange frequencies. […] Between vertigo attacks, balance returns to normal for most people with Menieres disease. But you might have some ongoing balance problems. […] Tests that study how well the inner ear is working include: […] Electronystagmogram or videonystagmography (ENG or VNG) These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your health care provider may use warm and cold air or water in the ear for the caloric test. […] Rotary-chair testing Like a VNG, this test measures how well your inner ear works based on eye movement. You sit in a computer-controlled chair that spins from side to side, which triggers activity in your inner ear. […] Vestibular evoked myogenic potentials (VEMP) testing This test uses sound to make parts of the inner ear active. It records how well muscles react to that sound. It may show common changes in the affected ears of people with Menieres disease. […] Computerized dynamic posturography (CDP) This test shows which part of the balance system you rely on the most and which parts may cause problems. The parts of the balance system include vision, inner ear function, or feelings from the skin, muscles, tendons and joints. While wearing a safety harness, you stand barefoot on a platform. Then you keep your balance under different conditions. […] Video head impulse test (VHIT) This test looks at how well the eyes and inner ears work together. VHIT uses video to measure eye reactions to sudden movement. While you focus on a point, your head is turned quickly and unpredictably. If your eyes move off the target when your head is turned, you have a reflex issue. […] Electrocochleography (ECOG) This test looks at how the inner ear reacts to sounds. It can help see if you have inner ear fluid buildup. But this test isnt given only for Menieres disease.

• #1 Vestibular diagnosis and testing | Ménière’s Society

  https://www.menieres.org.uk/information-and-support/visiting-ent-diagnosis-and-testing

  The MRI scan is a diagnosis of exclusion. As there is no definitive test for Mnires disease other causes of the symptoms need to be excluded and a normal test is sought. […] VEMPs can be cervical or ocular. The established of the two is the cervical or C-VEMP. […] Evidence supporting the use and interpretation of this test is increasing and it is hoped that it will become more routinely available over the next few years.

• #1 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  Electronystagmography […] Electronystagmography (ENG) allows the localization of the pathological process to the peripheral end-organ and rules out central causes of the patients symptoms. It will also allow the determination of the ear affected by Menieres disease, with the caveat that ENG testing can be normal early in the disease process. As found by Dobie et al, only 49% of patients with Menieres disease will display unilateral weakness on caloric stimulation, whereas 25% will show normal findings. […] Electrocochleography […] Electrocochleography (EcoG) is used to identify a hydropic state within the labyrinth. As reported by Coats, Morrison et al, and Ferraro et al, a prolonged summating potential and an elevated summating potential:compound action potential ratio is indicative of endolymphatic hydrops. Despite these assertions, only 62% of patients with Menieres disease display an elevated summating potential:compound action potential ratio compared with 21% of controls.

• #1 Meniere’s Disease ENT Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/dizziness-balance/menieres-disease/

  Electrocochleography (ECoG) may indicate increased inner ear fluid pressure in some cases of Mnires disease. […] The auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computed tomography (CT) or, magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing and balance nerve. Such tumors are rare, but they can cause symptoms similar to Mnires disease.

• #1 Meniere’s Disease: Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15167-menieres-disease

  Brain magnetic resonance imaging (MRI) with contrast: This imaging test helps to rule out potential brain tumors or other issues that may cause dizziness or hearing loss. […] There isnt a cure for Mnires disease, but treatments can reduce how severe and long-lasting your attacks are. Your healthcare provider will recommend conservative treatments first, like lifestyle changes, medication and therapy. If these treatments dont help, you may need surgery. […] Medications for Menieres disease include pills you take by mouth, such as: […] Diuretics (water pills) and betahistine: Your provider may prescribe diuretics to reduce the amount of fluid in your body. Or they may prescribe betahistine, which relieves fluid pressure by improving blood flow and circulation in your inner ear. […] Motion sickness and anti-nausea medications: These medications help control vertigo episodes, and some ease the nausea and vomiting from the spinning. Medicines include diazepam (Valium) and meclizine (Antivert).

• #1 Ménière disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/meniere-disease?lang=us

  The role of imaging for Mnire disease is controversial, but a number of findings on high-resolution CT and MRI have been associated with the disease. […] During the past decade, the morphologic substrate of Mnire disease, i.e. endolymphatic hydrops, has become visible using high resolution MRI techniques. […] Contrast-enhanced techniques have emerged as a promising modality for assessment of Mnire disease.

• #1 Meniere’s disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/menieres-disease/diagnosis-treatment/drc-20374916

  Your healthcare provider does an exam and asks about your health history. A Meniere’s disease diagnosis needs to include: […] Two or more vertigo attacks, each lasting 20 minutes to 12 hours, or up to 24 hours. […] Hearing loss proved by a hearing test. […] Tinnitus or a feeling of fullness or pressure in the ear. […] Meniere’s disease can have similar symptoms that are similar to other illnesses. Because of this, your healthcare provider will need to rule out any other conditions you may have. […] Lab tests, imaging scans and other tests may be used to rule out conditions. Some other conditions can cause problems like those of Meniere’s disease, such as a brain tumor or multiple sclerosis. […] For Meniere’s disease, some basic questions to ask your healthcare provider include: […] What tests do I need? […] Are there brochures or other printed material I can have? What websites do you suggest?

• #1 Ménière’s Disease – American Hearing Research Foundation

  https://www.american-hearing.org/disease/menieres-disease/

  Mnires disease (Menieres) is a disorder of the inner ear that sometimes seems to carry with it more questions than answers. […] Although it can come on at any age, most people with Mnires are 40 or older. […] Mnires is called a disease, but it really is a cluster of symptoms for which the underlying cause is unknown and for which there currently is no cure. […] Named after the French physician, Prosper Mnire, who first identified the disorder in 1861 as being linked to the inner ear rather than to the brain as once thought, Mnires is a particularly intrusive disorder that can be difficult to diagnose. […] The symptoms of Mnires aren’t singularly unique. Nor are they uniform among everyone who has it. These two factors make Mnires challenging to diagnose. […] Yet, its uncertainty that really characterizes Mnires. The inability to specifically identify the pathology of what is prompting the symptoms of Mnires sets it apart as its own disorder.

• #1 Meniere’s Disease: Symptoms, Diagnosis, and Treatment

  https://www.hearingtracker.com/resources/menieres-disease

  Since Menieres symptoms fluctuate, it is possible that these tests all show normal results. Because of this, a Menieres assessment from an Otologist will often also include a specialized test called electrocochleography, or EcoG, which measures the electro-chemical behavior of the cochlea. Patients with active Menieres show a specific result on ECoG, which can aid in the diagnosis. […] One of the challenges in diagnosing Menieres is the fluctuating nature of the disorder. While it would be ideal to perform all of the above test during an acute attack, most patients will not come into an office while the world is spinning and their ears are roaring. If you can provide a very accurate history including the approximate dates, duration and severity of the symptoms, your physician and audiologist can arrive at an accurate diagnosis even if your appointment is on a good day.

• #1 Ménière’s Disease – American Hearing Research Foundation

  https://www.american-hearing.org/disease/menieres-disease/

  Diagnosing Mnires is difficult because the symptoms overlap with many other diseases and conditions. […] When assessing someone for Mnires, physicians typically will review the person’s symptoms and medical history in detail and use a number of diagnostic tests to evaluate hearing and balance. […] If the doctor believes additional testing is needed to rule out certain underlying conditions that potentially could be causing the symptoms, a CT (computed tomography) scan and/or MRI (magnetic resonance imaging) may be part of the diagnostics used.

• #1 Meniere disease: Evaluation, diagnosis, and management – UpToDate

  https://www.uptodate.com/contents/meniere-disease-evaluation-diagnosis-and-management/print

  Meniere disease (MD), named for French physician Prosper Ménière, is a condition characterized by episodic vertigo, tinnitus, and hearing loss. This topic will present an overview of the diagnosis and treatment of MD. More detailed topics addressing the differential diagnosis of vertigo, tinnitus, and hearing loss are presented separately. […] Meniere disease – The classic triad of symptoms (episodic vertigo, tinnitus, and hearing loss), likely caused by endolymphatic hydrops of the labyrinthine system of the inner ear. […] This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options.

• #1 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  Menieres disease has been called the great masquerader because many clinical entities present with similar histories, signs, and symptoms. A variety of conditions can produce endolymphatic hydrops, so a thorough history is crucial. […] The treatment of any ailment should always begin with education of the patient. Often, patients will initially present with information regarding the various causes of dizziness. With the glut of information that is present on the Internet, clinicians must realize their role as educators who provide knowledge in addition to simply information. This education should begin with an explanation of Menieres disease, the expected course of the symptoms, and the treatment options. […] In treating Menieres disease, we take a stepped approach utilizing a clinical ladder progressing from a conservative approach considering the symptoms associated with Menieres disease. Treatment begins first with medical management. The majority of our patients achieve satisfactory control of their symptoms with diuretics and diazepam. Surgical options are considered only if the patient experiences unacceptable results with this approach.

• #1 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  Menieres Disease: Diagnosis and Management […] This chapter reviews the characteristics of the patient suffering from Menieres disease, the pathophysiology, the diagnostic workup, and the senior authors (RJW) approach in treatment. […] History is most valuable in the assessment of the patient with Menieres disease, for early in the process, diagnostic tests are not conclusive. Furthermore, the clinician rarely sees the patient during an acute attack. Between attacks, the physical examination yields little. Thus an accurate and thorough history is imperative. Menieres disease is most often seen during middle age. There is a slight predisposition toward females (1.3:1) whereas no racial preponderance is seen. Genetic predisposition is likely because Morrison has given credible evidence that Menieres can be inherited in ~20% of cases.

• #1 Meniere’s Disease | ENT & Allergy of Delaware

  https://entad.org/resources/patient-information-dr-teixido/endolymphatic-hydrops-menieres-disease/

  The diagnosis of Menieres disease is usually made by identifying the cardinal symptoms of ear fullness, fluctuating hearing loss, episodic vertigo and characteristic roaring or seashell tinnitus. […] In addition to a history and physical examination you will be asked to undergo some diagnostic studies to rule-out causes for your symptoms other than an inner ear disorder. This may take the form of blood tests, hearing tests, x-rays, CT scans or MRI scans of the brain and inner ear or electrocochleography. […] Perhaps the most important testing for any patient with Menieres disease is serial audiometry. An audiometric examination (hearing test) is performed to look for characteristic types of hearing loss in the affected ear. […] Because the hearing can change from day to day in patients with Menieres disease, audiograms on sequential visits are obtained to look for signs of fluctuating hearing levels that are characteristic of Menieres disease.

• #1 Meniere’s disease: treatment of vertigo and balance problems | University of Iowa Health Care

  https://uihc.org/services/menieres-disease

  Meniere’s disease is a disorder of the inner ear that can affect balance and hearing. It causes vertigo and hearing loss, which can have a big impact on your quality of life. […] Its symptoms are the same as those of some other diseases, so its often misdiagnosed. To get the right diagnosis and effective treatment, you need an experienced care team. […] After a thorough physical examination, youll likely have a hearing test (audiogram). Based on those results, you may need other tests, including: […] Your specialist may also have you evaluated by a neurologist in the UI Health Care balance disorders clinic. This will rule out migraines or other neurological conditions that can cause vertigo. […] Our team members work together to make sure you get the right diagnosis and the most effective treatment.

• #1 Meniere’s Disease: Diagnosis and Management   – PcMED Project

  https://pcmedproject.com/ent/menieres-disease-diagnosis-and-management/

  Meniere’s disease (MD) is a clinical condition characterized by recurrent bouts of vertigo in association with the hallmark symptoms of tinnitus and hearing loss. […] Early diagnosis and initiation of MD therapy can improve quality of life, decrease the risk of disability due to vertigo attacks and progressive hearing loss, and lead to decreased health care costs. […] The diagnosis is made clinically based on defined criteria. […] It may take months or years to reach a diagnosis of MD given the relapsing and intermittent nature of its presentation. […] If MD is suspected clinicians should obtain an audiogram to evaluate for subclinical hearing loss and establish baseline hearing. […] Doctors may offer MRI to rule out inner ear or retrocochlear lesions in patients who present with asymmetric hearing loss.

• #1 Meniere Disease (Idiopathic Endolymphatic Hydrops) Workup: Approach Considerations, Laboratory Studies, MRI and CT Scanning

  https://emedicine.medscape.com/article/1159069-workup

  Using 3-dimensional fluid-attenuated inversion recovery MRI (3D-FLAIR MRI), quantitative assessments of endolymphatic hydrops (EH) were found to correlate with the severity of hearing impairment in patients with Mnire disease. […] Multiple hearing tests, which document fluctuating hearing loss, are helpful in diagnosing Mnire. […] ECOG measures the ratio of the summating potential (probably from the movement of the basilar membrane) and the nerve action potential in response to auditory stimuli. Hydrops (elevated pressure) is suggested when this ratio is greater than 35%. The test is most accurate when Mnire disease is active. […] ENG is a test of inner ear function (particularly the horizontal semicircular canals). The test determines inner ear responsiveness to movement and caloric stimulation.

• #1 Endolymphatic Hydrops (Meniere’s Disease) Tests – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/500_599/0571.html

  This Clinical Policy Bulletin addresses endolymphatic hydrops (Meniere’s disease) tests. […] Aetna considers dehydration testing with glycerol, urea, or other osmotic diuretics to verify the suspicion of endolymphatic hydrops (Meniere’s disease) medically necessary only in members with atypical presentations of this disease. […] Aetna considers dehydration testing experimental, investigational, or unproven for other indications because its effectiveness has not been established. […] Aetna considers the following experimental, investigational, or unproven because their effectiveness for these indications has not been established: Genetic testing of KCNE1, KCNE3, SIK1, SLC8A1, and SLC26A4 gene mutation for the diagnosis of endolymphatic hydrops (Meniere’s disease). […] The vestibular evoked myogenic potential (VEMP) is a newer test that shows promise for diagnosis and monitoring.

• #2 Meniere Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536955/

  Meniere disease is an inner ear disorder characterized by tinnitus, vertigo, and hearing loss. […] The current diagnostic criteria defined by the Barany society by Lopez-Escamez, et al. can help differentiate between probable and definite Meniere’s disease. […] Patients with a definite Meniere disease, according to the Barany Society, have: Two or more spontaneous episodes of vertigo with each lasting 20 minutes to 12 hours; Audiometrically documented low- to medium-frequency sensorineural hearing loss in one ear, defining and locating to the affected ear on in at least one instance prior, during, or after one of the episodes of vertigo; Fluctuating aural symptoms (fullness, hearing, tinnitus) located in the affected ear; Not better accounted for by any other vestibular diagnosis. […] Probable Meniere disease can include the following clinical findings: Two or more episodes of dizziness or vertigo, each lasting 20 minutes to 24 hours; Fluctuating aural symptoms (fullness, hearing, or tinnitus) in the affected ear; The condition is better explained by another vestibular diagnosis.

• #2 Ménière’s disease – Wikipedia

  https://en.wikipedia.org/wiki/M%C3%A9ni%C3%A8re%27s_disease

  Mnire’s disease is characterized by recurrent episodes of vertigo, fluctuating hearing loss, and tinnitus; episodes may be preceded by a headache and a feeling of fullness in the ears. […] Diagnosis is based on the symptoms and a hearing test. […] The diagnostic criteria as of 2015 define definite MD and probable MD as: […] Definite: Two or more spontaneous episodes of vertigo, each lasting 20 minutes to 12 hours; Audiometrically documented low- to medium-frequency sensorineural hearing loss in the affected ear on at least one occasion before, during, or after one of the episodes of vertigo; Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear; Not better accounted for by another vestibular diagnosis. […] Probable: Two or more episodes of vertigo or dizziness, each lasting 20 minutes to 24 hours; Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the reported ear; Not better accounted for by another vestibular diagnosis.

• #2 What Is Ménière’s Disease? — Diagnosis and Treatment

  https://www.nidcd.nih.gov/health/menieres-disease

  How is Mnires disease diagnosed? […] Mnires disease is most often diagnosed and treated by an otolaryngologist (commonly called an ear, nose, and throat doctor, or ENT). There is no definitive test or single symptom that a doctor can use to make a diagnosis. Your doctor may suggest a hearing screening to identify any hearing loss. To rule out other diseases, magnetic resonance imaging (MRI) or computed tomography (CT) scans of the brain may be recommended. […] A diagnosis of definite Mnires disease is based on your medical history and on the presence of: […] Two or more spontaneous episodes of vertigo lasting 20 minutes to 12 hours. […] Hearing loss in one or both ears for low to medium frequency sounds, documented by a hearing test before, during, or after one of the episodes of vertigo.

• #2 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  To assist in identifying those patients most likely to have Menieres disease, the American Academy of Otolaryngology -Head and Neck Surgery (AAO-HNS) Committee on Hearing and Equilibrium has developed a diagnostic guideline as seen in Table 121. Though most patients display unilateral disease, 30 to 40% will ultimately develop bilateral disease. […] Diagnostic Evaluation […] Audiometry […] Patients with Menieres disease are classically described as having low-frequency sensorineural hearing loss, though Friberg et al have reported a flat pure-tone audiogram in 21% at initial audiogram. Further testing will often reveal diplacusis and recruitment. Fluctuations in pure-tone thresholds can be demonstrated, although the natural history is continued deterioration over several years, with few becoming profoundly deaf (1-2%).

• #2 Meniere’s Disease ENT Treatment in Utah – ENT Center of Utah

  https://entcenterutah.com/adult-care/dizziness-balance/menieres-disease/

  Mnires disease, also called idiopathic endolymphatic hydrops, is a disorder of the inner ear. […] Your physician will take a history of the frequency, duration, severity, and character of your attacks, the duration of hearing loss or whether it has been changing, and whether you have had tinnitus or fullness in either or both ears. Tests may be ordered to look for these problems in certain cases. When the history has been completed, diagnostic tests will check your hearing and balance functions. […] An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patients ability to distinguish words) is often diminished in the affected ear. […] A VNG (videonystagmograph) may be performed to evaluate balance function. In a darkened room, recording electrodes are placed near the eyes. Warm and cool water or air are gently introduced into each ear canal. Since the eyes and ears work in coordination through the nervous system, measurement of eye movements can be used to test the balance system. In many patients, the balance function is reduced in the affected ear.

• #2 Meniere’s Disease Treatment | Advanced Hearing & Balance Specialists

  https://advancedhearingdocs.com/menieres-disease-treatment/

  Diagnosing Menieres Disease requires a detailed examination by an ear specialist. This may include: […] A full medical background helps the doctor rule out other conditions that might have symptoms similar to Menieres Disease. […] A physical test is very important to check how well a patients ears and balance work. The doctor might use a tool called an otoscope to look inside the ear for swelling or fluid. They might also do tests like audiometry to check hearing levels and tympanometry to see how the middle ear works. […] To do this, the person must take hearing tests like speaking, pure tone, and tympanometry. These tests show what kind of hearing loss you have and how serious it is. This helps with diagnosis and treatment. […] Vestibular testing checks how well the balance system works. The Dix-Hallpike technique and caloric testing are two tests used to find common problems like positional vertigo. These tests help ensure the diagnosis is correct by looking for balance issues. […] An MRI is not usually used to find Menieres Disease. However, it might be suggested that other conditions, like acoustic neuromas or tumors, be ruled out.

• #2 Meniere disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/155

  Meniere disease (MD) is an episodic auditory and vestibular disease characterized by sudden onset of vertigo, hearing loss, tinnitus, and sensation of fullness in the affected ear. […] Diagnosis is made on clinical history and detailed audiology tests; other investigations may be required to exclude other causes. […] Key diagnostic factors include vertigo, hearing loss, tinnitus, aural fullness, and drop attacks. […] Diagnostic tests include pure-tone air and bone conduction with masking, speech audiometry, tympanometry/immittance/stapedial reflex levels, and otoacoustic emissions (OAE). […] Tests to consider include electrocochleography, electronystagmography, rotary chair test, vestibular-evoked myogenic potential (VEMP), MRI of internal auditory canals, thyroid function tests, Lyme disease and syphilis serology, antinuclear antibody, antineutrophil cytoplasmic antibody, and rheumatoid factor. […] Emerging tests include 3-dimensional MRI.

• #2 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  Electronystagmography […] Electronystagmography (ENG) allows the localization of the pathological process to the peripheral end-organ and rules out central causes of the patients symptoms. It will also allow the determination of the ear affected by Menieres disease, with the caveat that ENG testing can be normal early in the disease process. As found by Dobie et al, only 49% of patients with Menieres disease will display unilateral weakness on caloric stimulation, whereas 25% will show normal findings. […] Electrocochleography […] Electrocochleography (EcoG) is used to identify a hydropic state within the labyrinth. As reported by Coats, Morrison et al, and Ferraro et al, a prolonged summating potential and an elevated summating potential:compound action potential ratio is indicative of endolymphatic hydrops. Despite these assertions, only 62% of patients with Menieres disease display an elevated summating potential:compound action potential ratio compared with 21% of controls.

• #2 Meniere’s Disease I Ohio State Medical Center

  https://wexnermedical.osu.edu/ear-nose-throat/hearing-and-balance/menieres-disease

  We provide state-of-the-art diagnostic tools and treatment options to people who have Menieres disease. […] The Department of Otolaryngology Head and Neck Surgery at the Ohio State Wexner Medical Center has a dedicated staff that performs the most advanced testing, which helps ensure you are properly diagnosed so that your treatment can be as effective as possible, and you can return to health faster. […] There is no definitive test for Menieres disease. Instead, our audiologists and ENT physicians will investigate the pattern of your symptoms, including multiple vertigo episodes and hearing loss. Well use a combination of other evaluations to make a definitive diagnosis. Those tests include: […] Hearing testsThese are performed by trained audiologists. […] Dynamic vestibular testingThis could include an electronystagmogram or videonystagmography (ENG or VNG), both of which observe eye movements and brain function as they relate to balance.

• #2 Understanding Meniere’s Disease: Symptoms, Diagnosis, and Treatment Options – THANC Hospital

  https://thanchospital.com/understanding-menieres-disease-symptoms-diagnosis-treatment-options/

  DIAGNOSIS : […] A hearing test is called audiometry. Audiometry looks at how well you hear sounds at different pitches and volumes. It can also test how well you can tell between words that sound the same. People with Menieres disease often have trouble hearing low frequencies or combined high and low frequencies. They may have typical hearing in the midrange frequencies. […] Between vertigo attacks, balance returns to normal for most people with Menieres disease. But you might have some ongoing balance problems. […] Tests that study how well the inner ear is working include: […] Electronystagmogram or videonystagmography (ENG or VNG) These tests measure balance by studying eye movement. One part of the test looks at eye movement while your eyes follow a target. One part studies eye movement while your head is put in different positions. A third test, called the caloric test, follows eye movement by using temperature changes to trigger a reaction from the inner ear. Your health care provider may use warm and cold air or water in the ear for the caloric test. […] Rotary-chair testing Like a VNG, this test measures how well your inner ear works based on eye movement. You sit in a computer-controlled chair that spins from side to side, which triggers activity in your inner ear. […] Vestibular evoked myogenic potentials (VEMP) testing This test uses sound to make parts of the inner ear active. It records how well muscles react to that sound. It may show common changes in the affected ears of people with Menieres disease. […] Computerized dynamic posturography (CDP) This test shows which part of the balance system you rely on the most and which parts may cause problems. The parts of the balance system include vision, inner ear function, or feelings from the skin, muscles, tendons and joints. While wearing a safety harness, you stand barefoot on a platform. Then you keep your balance under different conditions. […] Video head impulse test (VHIT) This test looks at how well the eyes and inner ears work together. VHIT uses video to measure eye reactions to sudden movement. While you focus on a point, your head is turned quickly and unpredictably. If your eyes move off the target when your head is turned, you have a reflex issue. […] Electrocochleography (ECOG) This test looks at how the inner ear reacts to sounds. It can help see if you have inner ear fluid buildup. But this test isnt given only for Menieres disease.

• #2 Testing for Meniere’s disease

  https://dizziness-and-balance.com/disorders/menieres/testing.html

  Whats new: VHIT plus caloric testing is a recent addition to the diagnostic repertoire. Serial audiometry is still the best method. […] A patient who fits clinical criteria for Meniere’s, but who is without any previous testing, is usually asked to undergo the following procedures: Hearing testing (audiometry), with tympanometry and OAE. (hearing should be down). A time series of audiograms, if available, should show fluctuation and low-tone. […] Recent data suggests that combining the VHIT and VENG (caloric) test may be sensitive to Meniere’s, as VHIT is normal, but VENG is abnormal in Meniere’s. […] MRI testing is very low yield in patients with „definite or probable” Meniere’s disease. […] In brief, the reasons are: 1). Confirm the diagnosis 2). Rule out common alternatives 3). Follow progress of the disorder.

• #2 Meniere’s disease: Symptoms, diagnosis and treatment. Clínica Universidad de Navarra

  https://www.cun.es/en/diseases-treatments/diseases/meniere-disease

  In the diagnosis of Menire’s disease, otolaryngological examination includes ear, nostrils, nasopharynx, oral cavity and larynx. […] The specific exploration of the vestibular system is based on the study of a reflex phenomenon, called nystagmus, which is an eye movement in two phases of different speed, one fast and the other slow, which is justified by the connections that exist in the brain between the vestibular system and the nuclei of the eye movements. […] Other diagnostic tests are the caloric test and the rotary accelerations. For this purpose, two state-of-the-art equipment are available, such as video-staging and rotary sinusoidal stimulation. […] Dynamic posturography is a new scanning technique that allows a global evaluation of the equilibrium.

• #2 Meniere Disease (Idiopathic Endolymphatic Hydrops) Workup: Approach Considerations, Laboratory Studies, MRI and CT Scanning

  https://emedicine.medscape.com/article/1159069-workup

  Using 3-dimensional fluid-attenuated inversion recovery MRI (3D-FLAIR MRI), quantitative assessments of endolymphatic hydrops (EH) were found to correlate with the severity of hearing impairment in patients with Mnire disease. […] Multiple hearing tests, which document fluctuating hearing loss, are helpful in diagnosing Mnire. […] ECOG measures the ratio of the summating potential (probably from the movement of the basilar membrane) and the nerve action potential in response to auditory stimuli. Hydrops (elevated pressure) is suggested when this ratio is greater than 35%. The test is most accurate when Mnire disease is active. […] ENG is a test of inner ear function (particularly the horizontal semicircular canals). The test determines inner ear responsiveness to movement and caloric stimulation.

• #2 Meniere’s Disease

  http://www.earcentergreensboro.com/medical-education/menieres_disease.php

  Evaluation of the inner ear balance system and its connections to the central nervous system are done by a test called „electronystagmography” (ENG). […] A new test, vestibular evoked myopotentials, VEMP, are now being used to test patients who are suspected of having Meniere’s Disease. […] The hearing nerve and hearing pathways within the brain can be measured by a special computerized test called an „Auditory Brainstem Response Test” or ABR. […] Several tests of inner ear function are available. One test called „Otoacoustic Emissions” or OAE is performed to evaluate the health of tiny inner ear hair cells (the outer hair cells). […] An image of the brain and hearing/balance nerves can be made by performing a brain scan called a „Magnetic Resonance Imaging” (MRI) Scan. […] Measurements of hemoglobin, blood sugar (glucose), cholesterol, immune system status, liver, kidney, thyroid function testing, and testing for infectious diseases such as syphilis, lyme disease, and infectious mononucleosis may be among the studies needed to rule out other conditions that may cause symptoms similar to those found in Meniere’s disease. […] There is no single study that diagnoses Meniere’s disease with absolute certainty. Ultimately, the patient and a skilled ear specialist must evaluate the history, physical examinations, entire clinical picture, and test results together in order to arrive at a diagnosis.

• #2 Meniere Disease – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/inner-ear-disorders/meniere-disease

  Meniere disease is an inner ear disorder that causes vertigo, nausea, fluctuating sensorineural hearing loss, and tinnitus. There is no reliable diagnostic test. […] The diagnosis of Meniere disease is made clinically. The simultaneous combination of fluctuating low-frequency sensorineural hearing loss, episodic vertigo, ipsilateral fluctuating aural fullness, and tinnitus is characteristic. […] Patients with symptoms suggesting Meniere disease should have an audiogram and an MRI (with gadolinium enhancement) of the central nervous system with attention to the internal auditory canals to exclude other causes. Audiogram typically shows a low-frequency sensorineural hearing loss in the affected ear that fluctuates between tests. […] Testing is with audiogram, and MRI is done to rule out other disorders.

• #2 Meniere’s Disease I Ohio State Medical Center

  https://wexnermedical.osu.edu/ear-nose-throat/hearing-and-balance/menieres-disease

  Positional testing of semicircular canalsThis test examines how the eye jumps when the head is moved in different positions, such as side to side. […] Caloric reflex (stimulation) testsWe can test for a weakened inner ear by placing cold or warm air or water into the ear canal and seeing how it responds. […] Magnetic resonance imaging (MRI) or CT scansThese noninvasive imaging tests create detailed pictures of the body to rule out other conditions that could cause similar symptoms.

• #2 Endolymphatic Hydrops (Meniere’s Disease) Tests – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/500_599/0571.html

  The authors concluded that this study demonstrated that endolymphatic hydrops in the cochlea and vestibule were readily visualized using IV-Gd MRI; and hydrops image by IV-Gd MRI may be a reliable method for diagnosing MD. […] The authors concluded that these findings indicated that extra-tympanic ECoG has limited value in diagnosing MD during the early symptomatic period. […] Guidelines on Meniere’s disease from the American Academy of Otolaryngology – Head and Neck Surgery (Basura, et al., 2020) state: „Clinicians should not routinely order vestibular function testing or electrocochleography (ECochG) to establish the diagnosis of Meniere’s disease.” […] Furthermore, an UpToDate review on „Meniere disease: Evaluation, diagnosis, and management” (Moskowitz and Dinces, 2020) states that „Other testing may be used as part of the evaluation of MD, but these tests are not standardized and are not widely available for clinical use.”

• #2 Ménière’s disease – Wikipedia

  https://en.wikipedia.org/wiki/M%C3%A9ni%C3%A8re%27s_disease

  A common and important symptom of MD is hypersensitivity to sounds. […] Symptoms of MD overlap with migraine-associated vertigo (MAV) in many ways, but when hearing loss develops in MAV, it is usually in both ears, and this is rare in MD, and hearing loss generally does not progress in MAV as it does in MD. […] People who have had a transient ischemic attack (TIA) or stroke can present with symptoms similar to MD, and in people at risk magnetic resonance imaging should be conducted to exclude TIA or stroke. […] Other vestibular conditions that should be excluded include vestibular paroxysmia, recurrent unilateral vestibulopathy, vestibular schwannoma, or a tumor of the endolymphatic sac.

• #2 Meniere’s Disease: Symptoms, Diagnosis, and Treatment

  https://www.hearingtracker.com/resources/menieres-disease

  Since Menieres symptoms fluctuate, it is possible that these tests all show normal results. Because of this, a Menieres assessment from an Otologist will often also include a specialized test called electrocochleography, or EcoG, which measures the electro-chemical behavior of the cochlea. Patients with active Menieres show a specific result on ECoG, which can aid in the diagnosis. […] One of the challenges in diagnosing Menieres is the fluctuating nature of the disorder. While it would be ideal to perform all of the above test during an acute attack, most patients will not come into an office while the world is spinning and their ears are roaring. If you can provide a very accurate history including the approximate dates, duration and severity of the symptoms, your physician and audiologist can arrive at an accurate diagnosis even if your appointment is on a good day.

• #2 Meniere disease – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/meniere-disease/

  Asymmetric fluctuating hearing loss is a characteristic feature of Meniere disease. Subjective audiometry may be normal at the time of testing because the attacks of Meniere disease are episodic. […] Additional evaluation: Vestibular function tests and electrophysiologic testing are not routinely recommended. Indications: Atypical symptoms; Identifying the affected ear; Before vestibular ablative procedures. […] Imaging studies are not routinely indicated in patients with suspected Meniere disease. Indications: To rule out differential diagnosis in patients with atypical symptoms (e.g., sudden SNHL, nonfluctuating SNHL); Before ablative therapies.

• #2 Meniere’s Disease – Symptoms, Causes, Treatments

  https://www.healthyhearing.com/help/tinnitus/menieres-disease

  Meniere’s disease commonly affects people in various stages, with symptoms developing over time. […] Repeated bouts of tinnitus, hearing loss and vertigo are strong indicators of Meniere’s disease. Still, since all of these issues are common and can be associated with other diseases, Meniere’s can sometimes be difficult to diagnose. […] „A full and accurate diagnosis may take many months to attain,” write the authors of clinical practice guidelines published in the April 2020 issue of the Journal of OtolaryngologyHead and Neck Surgery. […] There is no single test to detect and diagnose Meniere’s disease. Testing can help rule out other conditions, though. […] Tests may include: A hearing test with an audiologist to detect and measure hearing loss. This is painless and non-invasive.

• #2 Menieres Disease | Otolaryngology⁠ — Head & Neck Surgery | Stanford Medicine

  https://med.stanford.edu/ohns/OHNS-healthcare/earinstitute/conditions-and-services/conditions/menieres-disease.html

  The diagnosis of Menieres disease is made on the basis of the symptoms it causes. There is no single test which proves that a patient has Menieres disease. There are tests that may help confirm the diagnosis and will exclude other diseases. These tests may include tests of hearing (audiogram), nerve recordings (vestibular evoked myogenic potentials or VEMPs), tests of balance (video nystagmogram (VNG) and video head impulse tests (vHITs)), blood tests, and possibly radiology scans of the head and ears (MRI).

• #2 Meniere’s Disease | ENT & Allergy of Delaware

  https://entad.org/resources/patient-information-dr-teixido/endolymphatic-hydrops-menieres-disease/

  The diagnosis of Menieres disease is usually made by identifying the cardinal symptoms of ear fullness, fluctuating hearing loss, episodic vertigo and characteristic roaring or seashell tinnitus. […] In addition to a history and physical examination you will be asked to undergo some diagnostic studies to rule-out causes for your symptoms other than an inner ear disorder. This may take the form of blood tests, hearing tests, x-rays, CT scans or MRI scans of the brain and inner ear or electrocochleography. […] Perhaps the most important testing for any patient with Menieres disease is serial audiometry. An audiometric examination (hearing test) is performed to look for characteristic types of hearing loss in the affected ear. […] Because the hearing can change from day to day in patients with Menieres disease, audiograms on sequential visits are obtained to look for signs of fluctuating hearing levels that are characteristic of Menieres disease.

• #2 Meniere’s Disease: Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/15167-menieres-disease

  Otolaryngologists (ENTs) diagnose Mnires disease. During your visit, your provider will perform a physical exam and neurological exam and ask about your symptoms. They may ask if you have regular episodes of vertigo and hearing loss. If you do, theyll ask about how severe they are and how long they last. […] They may do tests to rule out other potential conditions to confirm you have Mnires disease, including: […] Hearing test: The test will show if youve experienced hearing loss. During this test, a hearing specialist called an audiologist plays sounds through headphones. Youll press a button when you hear a sound. […] Vestibular test battery: Audiologists perform a series of tests to check the reflex of your inner ear (vestibular) balance system and eye muscles. Although your balance mostly returns to normal when youre not experiencing a vertigo attack, there may be leftover effects the tests can detect.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-of-Menieres-disease.aspx

  The criteria for diagnosis includes: Vertigo seen at least two spontaneous episodes lasting at least 20 minutes in a one attack of Mnire’s disease, Tinnitus and or feeling of fullness in the ear, Loss of hearing confirmed by audiometry testing. […] Hearing loss caused by the disease is tested using an audiometry test. […] An otoacoustic emission test is prescribed to check for the degree of damage to the hearing cells of the inner ears organ called the cochlea. […] An electrocochleography is performed to measure the electrical force generated in the cochlea of the inner ear and the nerve in response to stimulation by sound. This also detects the exact cause of hearing loss. […] Other diseases that need to be ruled out include: acoustic neuroma, ear infections (otitis media), ear wax, toxicity due to drugs and medications, stroke, brain tumors, migraine, anemia, thyroid under activity, diabetes, syphilis etc.

• #2 Ménière’s Disease | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.m%C3%A9ni%C3%A8re’s-disease.hw220237

  Mnire’s disease can cause symptoms that come on quickly and last from hours to days. […] See a doctor right away if you think you have Mnire’s disease. Prompt diagnosis and treatment may reduce both the discomfort of the attacks and your risk of hearing loss. […] Your doctor will do a physical exam that includes checking your ears, eyes, and nervous system. They’ll also ask about your past health and your symptoms, including: […] You will probably have a hearing test. Other tests, such as an MRI or a CT scan, may be done to help find out what is causing your symptoms.

• #2 Ménière’s Disease – Vestibular Disorders Association

  https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/menieres-disease/

  No treatment currently exists to cure Mnires disease. However, medical treatments exist that can help manage it. […] Existing treatments fall into two categories. Some treatments aim at reducing the severity of an attack while it is occurring, while other treatments attempt to reduce the severity and number of attacks in the long term. […] For the 20-40% of people who do not respond to medication or diet, a physician may recommend a treatment that involves more physical risk. […] The goal of the first type is to relieve the pressure on the inner ear. […] The goal of the second type of surgery is to block the movement of information from the affected ear to the brain.

• #2 Frontiers | Meniere’s Disease: From Diagnosis to Treatment

  https://www.frontiersin.org/research-topics/62397/menieres-disease-from-diagnosis-to-treatmentundefined

  Meniere’s disease is a set of rare inner ear disorders characterized by episodes of vertigo, tinnitus, aural fullness, and fluctuating hearing loss. […] Current understanding suggests that Meniere’s disease is linked to dysfunction in the volume regulation of endolymphatic fluid within the inner ear, although the complex physiological changes that initiate Meniere’s disease are still not entirely understood. […] Recent studies have focused on improving diagnostic accuracy through detailed clinical histories, audiometry, balance function tests, and imaging studies like MRI to rule out other conditions. […] Specific questions include identifying the underlying pathogenesis, improving diagnostic accuracy, and evaluating the efficacy of various treatment modalities. […] – Diagnostic value of vestibular tests in Menieres Disease – Diagnostic value of electrocochleography in Menieres Disease – Genetic diagnosis of Menieres Disease – Differentiation of Menieres Disease from Vestibular Migraine.

• #2 Ménière disease | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/meniere-disease?lang=us

  The role of imaging for Mnire disease is controversial, but a number of findings on high-resolution CT and MRI have been associated with the disease. […] During the past decade, the morphologic substrate of Mnire disease, i.e. endolymphatic hydrops, has become visible using high resolution MRI techniques. […] Contrast-enhanced techniques have emerged as a promising modality for assessment of Mnire disease.

• #2 Testing for Meniere’s disease

  https://dizziness-and-balance.com/disorders/menieres/testing.html

  Confirm diagnosis — Hearing loss (Audiogram); OAE and tympanometry to rule out alternatives to Meniere’s. […] Is hearing loss present? Meniere’s disease cannot be diagnosed without hearing loss. […] Characteristic VHIT/Caloric pattern (good VHIT, bad Caloric). This supports Hydropic inner ear disease. More practical than either ECOG or special MRI. […] The diagnosis of Meniere’s is a serious one, which has long term implications for deterioration in hearing and balance. Why confirm it (or rule it out?) […] Knowing that you have Meniere’s is important over the long term because Meniere’s is an uncurable, chronic illness. […] Meniere’s is often overdiagnosed — the Framingham study suggested that the condition is overdiagnosed by a factor of 10! If the diagnosis is wrong, it is best to get it „off the table” quickly.

• #2 Meniere’s Disease: Diagnosis and Management | Ento Key

  https://entokey.com/menieres-disease-diagnosis-and-management/

  Menieres disease has been called the great masquerader because many clinical entities present with similar histories, signs, and symptoms. A variety of conditions can produce endolymphatic hydrops, so a thorough history is crucial. […] The treatment of any ailment should always begin with education of the patient. Often, patients will initially present with information regarding the various causes of dizziness. With the glut of information that is present on the Internet, clinicians must realize their role as educators who provide knowledge in addition to simply information. This education should begin with an explanation of Menieres disease, the expected course of the symptoms, and the treatment options. […] In treating Menieres disease, we take a stepped approach utilizing a clinical ladder progressing from a conservative approach considering the symptoms associated with Menieres disease. Treatment begins first with medical management. The majority of our patients achieve satisfactory control of their symptoms with diuretics and diazepam. Surgical options are considered only if the patient experiences unacceptable results with this approach.

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