title: Menière's disease.
abstract: Menière's disease (MD) is a chronic multifactorial disorder of the inner ear characterized by episodic vestibular symptoms associated with sensorineural hearing loss, tinnitus, and aural pressure. Epidemiologic and genomic evidence supports a genetic susceptibility with multiple biochemical pathways involved, including the endocrine system, innate immune response, and autonomic nervous system. Allergens, infectious agents, vascular events, or genetic factors could modify inner-ear homeostasis and trigger MD. The diagnosis of MD is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing loss, tinnitus, and/or fullness) in the affected ear. Headache is also found during the attacks and bilateral involvement is found in 25-40% of cases. Audiologic and vestibular assessment is recommended to monitor the clinical course. The treatment of MD is symptomatic to obtain relief of vestibular episodes and preventive to limit hearing loss progression. Treatment options include sodium restriction, betahistine, intratympanic gentamicin, or steroids and eventually surgery, such as cochlear implantation.
authors.affiliation: Otology and Neurotology Group, Department of Genomic Medicine, Centre for Genomics and Oncological Research (GENYO), Pfizer-University of Granada-Junta de Andalucia, Granada, Spain; Department of Otolaryngology, Hospital San Agustin, Linares, Jaen, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Espinosa-Sanchez
authors.affiliation: Otology and Neurotology Group, Department of Genomic Medicine, Centre for Genomics and Oncological Research (GENYO), Pfizer-University of Granada-Junta de Andalucia, Granada, Spain; Department of Otolaryngology, Complejo Hospitalario Universitario de Granada, Granada, Spain. Electronic address: antonio.lopezescamez@genyo.es.
authors.forename: J A
authors.initials: JA
authors.lastname: Lopez-Escamez
mesh_terms: D001299:Audiometry; D001341:Autonomic Nervous System / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008575:Meniere Disease / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology
keywords: Betahistine; Endolymphatic hydrops; Intratympanic gentamicin; Intratympanic steroids; Sensorineural hearing loss; Vertigo