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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.
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
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.