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| |  DG Dispatch - Meniere's disease: Prism Glasses Alleviate Vertigo In Meniere's Patients By Tuy Nga Brignol Special to DG News
PARIS, FRANCE -- April 14, 1999 -- Prism glasses are effective in beating vertigo in Meniere’s disease patients, according to the results of a new study. P.E. M. Vente of the University Hospital Maastricht, The Netherlands, presented the findings at the 4th International Symposium on Meniere’s disease, April 11-14, 1999, in Paris, France. Spectacles with the addition of the correct prisms, according to the guidelines described by G.P. Utermöhlen in 1941, were prescribed to 363 patients with unilateral Meniere’s disease. Of these 146 were men and 217 were women, the average age being 45 years (13 to 83 years). Vertigo disappeared in 64 percent of patients (232) who remain free of symptoms; 14 percent of patients had no or only moderate improvement; 22 percent of patients reported significant improvement. Pressure Chamber Effective Treatment Of Symptoms Pressure chamber treatment has a positive effect on vertigo attacks, tinnitus and ear pressure, according to the results of a study presented by Karl-Eric Karlmar, MD, PhD, of Flight Medical Center & Department, Linköping, Sweden. In this study, 35 patients with Meniere’s disease who had not received surgical or medical treatment were exposed to 1,000 m (change of altitude at 10m/s), 2,000m and 2,300m. The time at each altitude was 10 mn, while zero level was retained for a few seconds. Change of altitude 1,000m to 0 was at 40m/s. Prior to and two to three days after the hypobaric event, the patients were monitored by audiometry. Some patients had an improved hearing, usually after a few days, lasting over weeks or even months. According to the questionnaire, more than half of the patients reported having less tinnitus and ear pressure for weeks after the treatment and also a marked decrease in vertigo attacks. Oxygenation Therapy Proves Effective As Maintenance Therapy Hyperbaric and alternobaric treatment prove to achieve best results as a maintenance therapy, according to the results of the study presented by A. Casani, E.N.T. Clinic, department of hyperbaric medicine, University of Pisa, Italy. Oxygenation therapy consisted of one 90-minute session per day for 15 days during the acute attacks followed by five consecutive sessions per month during a follow-up period of two years. A total 55 patients with Meniere’s disease (34 men, 21 women), with an average age of 48 +/- 12.1 years, were submitted to pressure chamber therapy, 20 of them with constant pressure and 35 with continuous variations in pressure levels. The 18 patients in the control group were treated with 10% I.V. glycerol during the acute episode and betahistine thereafter. Hypoacousia, vertigo and tinnitus were compared in the three groups 15 days after starting treatment and at the end of the follow-up (two years or four years). After 15 days, there were no statistical differences in recovery among the three groups. During the follow up period, hyperbaric and in particular alternobaric treatment permitted significant control of vertigo attacks. Hypoacousia showed more significant persistent improvement in the patients treated with alternobaric oxygenation compared to the patients in the other two groups. Gentamicin Effective In Unilateral And Bilateral Morbus Meniere’s Transtympanic application of gentamycin gives adequate control of vertigo in patients with unilateral and bilateral Meniere’s disease, according to the result of a retrospective study presented by Klaus Janhke of University of Essen, Germany. The researchers treated 76 patients with transtympanic application of gentamicin during a period of 10 years. The mean age was 50.9 years (19 to 74 years). The average follow-up period was 4.7 years. The objective measures were posturography, audiometry, calorics. Controls were carried out at two weeks, four weeks, three months, six months, one year and two years. Adequate control of vertigo was seen in 91 percent of cases (69 patients); three patients had a significant decrease in their hearing threshold. Among the seven patients who did not respond to treatment, four received translabyrintine vestibular neurectomy. In the bilateral group, the treatment achieved control of vertigo in seven out of eight cases.
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