The management of Meniere's disease often creates a formidable clinical challenge. Drugs may be helpful in treating the acute attacks of vertigo, and in more long-term management. These remedies are largely symptomatic and there are few properly controlled studies of their efficacy. A critical overview of the scientific and clinical basis for these various pharmacological agents is discussed.
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References
1.
ThomsenJ., BechP., PrytzS.Meniere's disease: Lithium treatment (demonstration of placebo effect in a double-blind cross-over trial). Clin Otolaryngol1979; 4: 119–23.
2.
PhilipszoonA.J.Influence of cinnarizine on the labyrinth and on vertigo. Clin Pharmacol Ther1962; 3(2): 184–90.
3.
KlockhoffI., LindblomU.Meniere's disease and hydrochlorothiazide: A critical analysis of symptoms and therapeutic effects. Acta Otolaryngol1967; 63: 347–65.
4.
FrewI.J.C., MenonG.W.Betahistine hydrochloride in Meniere's disease. Postgrad Med J1976; 52: 501–3.
5.
WilmotT.J., MenonG.W.Betahistine in Meniere's disease. J Laryngol Otol1976; 90: 833–40.
6.
TowseG.Cinnarizine: A labyrinthine sedative. J Laryngol Otol1980; 94: 1009–15.
7.
Van DeelenG.W., HuizingE.H.The use of a diuretic (Diazide) in the treatment of Meniere's disease. ORL1986; 48: 287–92.
8.
WennmoC., BergeniusJ., HenrikssonN.G.Transdermal scopolamine and dimenhydrinate in treatment of acute vertigo, in GrahamM.D., KeminkJ.L. (eds): The Vestibular System: Neurophysiologic and Clinical Research.New York, Raven Press, 1987.
TorokN.Old and new in Meniere's disease. Laryngoscope1977; 87: 1870–7.
11.
SilversteinH., SmouhaE., JonesR.Natural history versus surgery for Meniere's disease. Otolaryngol Head Neck Surg1989; 100: 6–16.
12.
WamsleyJ.K., LewisM.S., YoungW.S.Autoradiographic localization of cholinergic receptors in rat brainstem. J Neurosci1981; 1: 176–91.
13.
PalaciosJ.M., WamsleyJ.K., KuharM.J.The distribution of histamine Hl receptors in rat brain: An autoradiographic study. Neuroscience1981; 6: 15–37.
14.
TakedaN., MoritaM., HasegawaS.Neuropharmacology of motion sickness and emesis. Acta Otolaryngol (Stockh)1993; 501(Suppl): 10–15.
15.
KirstenE.B., SchoenerE.P., WangS.C.Effects of d-amphetamine on single vestibular neurones. J Pharmacol Exp Ther1974; 191: 377–83.
16.
JongkeesL.B.W., PhilipszoonA.J.Some nystagmographical methods for the investigation of the effects of drugs upon the labyrinth. Acta Physiol Pharmacol (Netherlands)1960; 9: 240–75.
17.
CobbS., CoenL.W., GitomerS.L.Effect of cinnarizine on nystagmus induced by rotation deceleration. ENT Month1976; 55: 24–30.
18.
O'DonoghueB.M.Anaesthesia for ENT surgery, in MorganM., HallG.H. (eds): Short Textbook of Anaesthesia.London, Churchill Livingstone, 1996. In press.
19.
ShinkawaH., KimuraR.S.Effect of diuretics on endolymphatic hydrops. Acta Otolaryngol (Stockh)1986; 101: 43–52.
Van NuetenJ.M., JanssenP.A.J.Comparative study of the effects of flunarizine and cinnarizine on smooth muscles and cardiac tissues. Arch Int Pharmacodyn Ther1973; 204: 37–55.
29.
Di PerriT., ForconiS., GuerriniM.Action of cinnarizine on the hyperviscosity of blood in patients with peripheral obliterative arterial disease. Angiology1979; 30: 13–20.
30.
De CreeJ., De CockW., GeukensH.The theological effects of cinnarizine and flunarizine in normal and pathologic conditions. Angiology1979; 10: 505–15.
31.
MartinezD.M.The effect of Serc (betahistine hydrochloride) on the circulation of the inner ear in experimental animals. Acta Otolaryngol1972; 305(SuppI): 29–47.
32.
LaurikainenE.A., MillerJ.M., QuirkW.S.Betahistine-induced vascular effects in the rat cochlea. Am J Otol1993; 14: 24–30.
33.
ArrangJ.M., GarbargM., QuackT.T.Action of betahistine and histamine receptors in the brain. Eur J Pharmacol1986; 111: 73–84.
34.
MeyerE.D.Treatment of Meniere's disease with betahistine dimesilate: Double-blind crossover study versus placebo. Laryngol Rhinol Otol Stuttg1985; 64: 269–72.
35.
WeintraubJ., ArenbergI.K., SpectorG.J.The efficacy of conservative medical regimens on the rate of hearing loss in Meniere's syndrome: A retrospective computerized statistical analysis. Laryngoscope1976; 86: 1391–6.
36.
BertrandR.A.Long-term evaluation of the treatment of Meniere's disease with betahistine HCl. Adv Otorhinolaryngol1982; 28: 104–10.
37.
ThorntonA.R.D., FarrellG., HaackeN.P.A non-invasive, objective test of endolymphatic hydrops. Acta Otolaryngol (Stockh)1991; 479(Suppl): 35–43.
38.
FutakiT., SembaT., KudoY.Treatment of hydropic patients by immunoglobulin with methyl B12. Am J Otol1988; 9: 131–5.
39.
ItohA., SakataE.Treatment of vestibular disorders. Acta Otolaryngol (Stockh)1991; 481(Suppl): 617–23.
40.
BrookesG.B., NewlandA.C.Plasma exchange in the treatment of immune-mediated sensorineural hearing loss. J Laryngol Otol1986; 100: 25–33.
41.
SchuknechtH.F.Ablation therapy for the relief of Meniere's disease. Acta Otolaryngol (Stockh)1957; 132(Suppl): 14–42.
42.
GrahamM.D., SataloffR.T., KeminkJ.L.Titration streptomycin therapy for bilateral Meniere's disease: A preliminary report. Otolaryngol Head Neck Surg1984; 92: 440–7.
43.
BeckC., SchmidtC.L.Ten years of experience with intratympanically applied streptomycin (gentamicin) in the therapy of morbus Meniere. Arch Otorhinolaryngol1978; 221: 149–52.
44.
WersallJ., BjorkrothF., FlockA.Experiments on ototoxic effects of antibiotics. Adv Otorhinolaryngol1973; 20: 14–41.
45.
NedzelskiJ.M., SchesselD.A., BryceG.E.Chemical labyrinthectomy: Local application of gentamicin for the treatment of unilateral Meniere's disease. Am J Otol1992; 13: 18–22.
46.
MollerC., OdkvistL.M., ThillJ.Vestibular and audiologic functions in gentamicin treated Meniere's disease. Otolaryngol Head Neck Surg1987; 9: 383–91.