title: Diagnostic and therapeutic strategy in Menière's disease. Guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL).
abstract: OBJECTIVE
  The authors present the guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (Société française d'oto-rhino-laryngologie et de chirurgie de la face et du cou: SFORL) for diagnostic and therapeutic strategy in Menière's disease.
  
  
  METHODS
  A work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, then read over by an editorial group independent of the work group. The guidelines were graded according to the literature analysis and recommendations grading guide published by the French National Agency for Accreditation and Evaluation in Health (January 2000).
  
  
  RESULTS
  Menière's disease is diagnosed in the presence of the association of four classical clinical items and after eliminating differential diagnoses on MRI. In case of partial presentation, objective audiovestibular tests are recommended. Therapy comprises medical treatment and surgery, either conservative or sacrificing vestibular function. Medical treatment is based on lifestyle improvement, betahistine, diuretics or transtympanic injection of corticosteroids or gentamicin. The main surgical treatments, in order of increasing aggressiveness, are endolymphatic sac surgery, vestibular neurotomy and labyrinthectomy.
authors.affiliation: Service ORL et chirurgie cervico-faciale, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
authors.forename: J
authors.initials: J
authors.lastname: Nevoux
authors.affiliation: Service ORL, hôpital Pellegrin, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Franco-Vidal
authors.affiliation: Inserm UMRS 1159, service ORL, université Pierre-et-Marie-Curie, CHU Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Bouccara
authors.affiliation: Service ORL, CHU de Nancy, EA 3450 DevAH, université de Loraine, 54035 Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Parietti-Winkler
authors.affiliation: Service ORL, hôpital Gui-de-Chauliac, CHU de Montpellier, 34090 Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Uziel
authors.affiliation: Service ORL et chirurgie de la face et du cou, CHU de Reims, Reims, France.
authors.forename: A
authors.initials: A
authors.lastname: Chays
authors.affiliation: Service ORL et chirurgie de la face et du cou, CHU de Reims, Reims, France.
authors.forename: X
authors.initials: X
authors.lastname: Dubernard
authors.affiliation: Service d'ORL pédiatrique et de chirurgie cervico-faciale, 149, rue de Sèvres, 75015 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Couloigner
authors.affiliation: Service ORL, hôpital Pellegrin, université de Bordeaux, 33076 Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Darrouzet
authors.affiliation: Inserm UMR 1107, service ORL, laboratoire de biophysique neurosensorielle, université d'Auvergne, CHU Gabriel-Montpied, Clermont-Ferrand, France. Electronic address: tmom@chu-clermontferrand.fr.
authors.forename: T
authors.initials: T
authors.lastname: Mom
mesh_terms: D006801:Humans; D003714:Denervation / Q000379:methods; D005602:France; D008575:Meniere Disease / Q000175:diagnosis / Q000601:surgery; D010036:Otolaryngology; D013506:Otologic Surgical Procedures; D012955:Societies, Medical; D016896:Treatment Outcome; D014722:Vestibule, Labyrinth / Q000601:surgery
keywords: Diagnostic criteria; Diagnostic tests; Menière's disease; Treatment