Clinical Practice Guideline: Ménière’s Disease Executive Summary

Author:

Basura Gregory J.1,Adams Meredith E.2,Monfared Ashkan3,Schwartz Seth R.4,Antonelli Patrick J.5,Burkard Robert6,Bush Matthew L.7,Bykowski Julie8,Colandrea Maria9,Derebery Jennifer10,Kelly Elizabeth A.11,Kerber Kevin A.1,Koopman Charles F.12,Kuch Amy Angie13,Marcolini Evie14,McKinnon Brian J.15,Ruckenstein Michael J.16,Valenzuela Carla V.17,Vosooney Alexis18,Walsh Sandra A.19,Nnacheta Lorraine C.20,Dhepyasuwan Nui20,Buchanan Erin M.20

Affiliation:

1. University of Michigan Medical Center, Ann Arbor, Michigan, USA

2. University of Minnesota, Minneapolis, Minnesota, USA

3. George Washington University, Washington, DC, USA

4. Virginia Mason Medical Center, Seattle, Washington, USA

5. University of Florida, Gainesville, Florida, USA

6. University of Buffalo, Buffalo, New York, USA

7. University of Kentucky Medical Center, Lexington, Kentucky, USA

8. University of California San Diego, San Diego, California, USA

9. Duke University School of Nursing and Durham Veterans Affairs Medical Center, Durham, North Carolina, USA

10. House Ear Clinic, Los Angeles, California, USA

11. Boys Town National Research Hospital, Omaha, Nebraska, USA

12. C.S. Mott Children’s Hospital, Ann Arbor, Michigan, USA

13. Vestibular Disorders Association, Portland, Oregon, USA

14. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA

15. Drexel University College of Medicine, Philadelphia, Pennsylvania, USA

16. University of Pennsylvania, Philadelphia, Pennsylvania, USA

17. Washington University School of Medicine, St Louis, Missouri, USA

18. Private practice, West St Paul, Minnesota, USA

19. Consumers United for Evidence-Based Healthcare, Baltimore, Maryland, USA

20. American Academy of Otolaryngology—Head and Neck Surgery, Alexandria, Virginia, USA

Abstract

Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many, and approaches typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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