Reviewing Meniere’s disease
Reviewed by Suzanne Jervis

This was a sizeable literature review (93 references) of not only the office-based treatments for Meniere’s disease but also the various aetiological theories regarding it. They also highlight the amended International Criteria for Meniere’s disease diagnosis (2015), comparing it against the AAOHNS 1995 criteria. They included a useful section on the crossover diagnoses between Meniere’s and vestibular migraine and the frequency of the diagnoses co-existing. The viral aetiological role in the literature with respect to Meniere’s disease was reviewed amongst other theories and thus they also discussed the anti-viral treatments. Interestingly, this appears to form the main part of their patient management, following failure of a low salt diet and diuretics. To my knowledge the use of antivirals within the UK for management is not usually practised, although the use of betahistine still continues. However, with large German RCT published in the BMJ Jan 2016 this is likely to alter practice. The review of the transtympanic gentamicin section I thought was very sparse considering the volumes of papers out there. However, this may soon be irrelevant if the OTO-104 trial with long acting dexamethasone produces the results we all hope for. There is clearly wide variability in the management of Meniere’s disease, largely as a result of low quality evidence, although this is slowly changing. However, if the authors are going to supplement a review with their own practice, robust data to back up their experience would be advised, otherwise it should be omitted.

Office-based Meniere’s disease management.
Bartels LJ, Danner CJ, Allen KP.
OPERATIVE TECHNIQUES IN OTOLARYNGOLOGY
2016:27(4);225-34.