HSC Section 8_April 2017

Goebel JA. 2015 Equilibrium Committee Amendment to the 1995 AAO-HNS Guidelines for the Definition of Ménière's Disease. Otolaryngol Head Neck Surg . 2016; 154(3):403-404. EBM level 5............................................................................................................................34-35 Summary : This article presents an expert opinion regarding the evolving definition of Ménière's disease, and describes the amendment to the 1995 AAO-HNS criteria for diagnosis of Ménière's disease. Gürkov R, Pyykö I, Zou J, Kentala E. What is Ménière’s disease? A contemporary re- evaluation of endolymphatic hydrops. J Neurol . 2016; 263 Suppl 1:S71-S81. EBM level 5......................................................................................................................................36-46 Summary : This is a narrative review of pathophysiology, clinical features, and diagnostic criteria for Ménière’s disease. The authors review the gadolinium-based MRI diagnosis of endolymphatic hydrops and discuss the grading system. They propose a new classification of hydropic disorder of inner ear. Summary : This study is a retrospective case review on management of intractable Ménière’s disease after intratympanic injection of gentamicin (ITG). Class A and B control was achieved by ITG in 90% of patients. Exploratory tympanotomy and gentamicin application (ETG) over the round and oval windows had a 71% success rate of class A outcome in patients who failed ITG. Labyrinthectomy and vestibular neurectomy were still needed in select patients who failed all other therapeutic modalities. Sood AJ, Lambert PR, Nguyen SA, Meyer TA. Endolymphatic sac surgery for Ménière’s disease: a systematic review and meta-analysis. Otol Neurotol . 2014; 35(6):1033-1045. EBM level 3a....................................................................................................................................54-66 Summary : This study is a systematic review and meta-analysis of endolymphatic sac surgery in Ménière’s disease from 1970 to 2013. Endolymphatic sac decompression and/or shunt, with or without silastic, was equally effective long term in over 75% of patients who failed medical therapy for vertigo of Ménière’s disease. The authors found that once the sac is opened, inserting silastic into the sac does not improve vertigo control and may diminish audition. C. Pulsatile tinnitus Ahsan SF, Seidman M, Yaremchuk K. What is the best imaging modality in evaluating patients with unilateral pulsatile tinnitus? Laryngoscope . 2015; 125(2):284-285. EBM level 5......................................................................................................................................67-68 Summary : This article is a review of five previous journal articles presenting evaluation methods for patients with pulsatile tinnitus. The authors review and identify the different methods of evaluation and their sensitivity and specificity for diagnosis, and include an evaluation tree for workup of pulsatile tinnitus. Rah YC, Han JJ, Park J, et al. Management of intractable Ménière’s disease after intratympanic injection of gentamicin. Laryngoscope . 2015; 125(4):972-978. EBM level 4....................47-53