Clinical Subgroups in Bilateral Meniere Disease.
Meniere disease (MD) is a heterogeneous clinical condition characterized by sensorineural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We have performed a two-step cluster analysis in 398 patients with bilateral MD (BMD) to identify the best predictors to define clinical subgroups with a potential different etiology to improve the phenotyping of BMD and to develop new treatments. We have defined five clinical variants in BMD. Group 1 is the most frequently found, includes 46% of patients, and is defined by metachronic hearing loss without migraine and without AD. Group 2 is found in 17% of patients, and it is defined by synchronic hearing loss without migraine or AD. Group 3, with 13% of patients, is characterized by familial MD, while group 4, that includes 12% of patients, is associated by the presence of migraine in all cases. Group 5 is found in 11% of patients and is defined by AD. This approach can be helpful in selecting patients for genetic and clinical research. However, further studies will be required to improve the phenotyping in these clinical variants for a better understanding of the diverse etiological factors contributing to BMD.
Otology and Neurotology Group CTS495, Department of Genomic Medicine - Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO) , Granada , Spain.
Lidia
L
Frejo
Department of Otorhinolaryngology, Division of Otoneurology, Complexo Hospitalario Universitario , Santiago de Compostela , Spain.
Andres
A
Soto-Varela
Department of Otorhinolaryngology, Division of Otoneurology, Complexo Hospitalario Universitario , Santiago de Compostela , Spain.
Sofía
S
Santos-Perez
Department of Otolaryngology, Complexo Hospitalario de Pontevedra , Pontevedra , Spain.
Ismael
I
Aran
Department of Otolaryngology, Hospital Universitario Salamanca , Salamanca , Spain.
Angel
A
Batuecas-Caletrio
Department of Otorhinolaryngology, Hospital Universitario La Fe , Valencia , Spain.
Vanesa
V
Perez-Guillen
Department of Otorhinolaryngology, Hospital Universitario La Fe , Valencia , Spain.
Herminio
H
Perez-Garrigues
Department of Otolaryngology, Hospital Miguel Servet , Zaragoza , Spain.
Jesus
J
Fraile
Department of Otolaryngology, Hospital Universitario de Getafe , Getafe , Spain.
Eduardo
E
Martin-Sanz
Department of Otorhinolaryngology, Instituto Antolí Candela , Madrid , Spain.
Maria C
MC
Tapia
Department of Otorhinolaryngology, Division of Otoneurology, Complejo Hospitalario Badajoz , Badajoz , Spain.
Gabriel
G
Trinidad
Department of Otorhinolaryngology, Hospital Universitario Vall d'Hebron , Barcelona , Spain.
Ana María
AM
García-Arumi
Department of Otorhinolaryngology, Hospital Universitario Marqués de Valdecilla , Santander, Cantabria , Spain.
Rocío
R
González-Aguado
Otology and Neurotology Group CTS495, Department of Genomic Medicine - Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain; Department of Otorhinolaryngology, Hospital San Agustin, Linares, Jaen, Spain.
Juan M
JM
Espinosa-Sanchez
Department of Otorhinolaryngology, Centro Hospitalar de São João, EPE, University of Porto Medical School , Porto , Portugal.
Pedro
P
Marques
Department of Otorhinolaryngology, Hospital Cabueñes , Gijón , Spain.
Paz
P
Perez
Department of Otolaryngology, Hospital Universitario de Gran Canaria Dr. Negrin , Las Palmas , Spain.
Jesus
J
Benitez
Otology and Neurotology Group CTS495, Department of Genomic Medicine - Centro de Genómica e Investigación Oncológica - Pfizer/Universidad de Granada/Junta de Andalucía (GENYO), Granada, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitalario Universidad de Granada (CHUGRA), Granada, Spain.
Jose A
JA
Lopez-Escamez
Meniere’s disease; autoimmune disorders; cluster analysis; hearing loss; inner ear; migraine; tinnitus; vestibular disorders