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Ménière's disease and delayed endolymphatic hydrops in children
K Mizukoshi1, H Shojaku, S Aso
1Health Services Facility for the Aged Amenity Nobukiyo, Toyama, Japan.
Insights
Pediatric Ménière
Area of Science:
- Otolaryngology
- Neurotology
- Pediatric Neurology
Background:
- Endolymphatic hydrops disorders, including Ménière's disease (MD) and delayed endolymphatic hydrops (DEH), are typically diagnosed in adults.
- Pediatric cases are rare, necessitating further characterization.
Purpose of the Study:
- To investigate the clinical characteristics of pediatric patients with endolymphatic hydrops.
- To identify specific features distinguishing pediatric MD and DEH.
Main Methods:
- Retrospective analysis of 7418 patients from 1979-1999.
- Selection of 5 pediatric MD and 3 pediatric DEH patients.
- Evaluation of clinical features, audiological tests, and electrophysiological findings.
Main Results:
- Pediatric MD constituted only 1.5% of all MD cases.
- Key findings in pediatric MD included fluctuating hearing loss, positive glycerol and furosemide tests, and a high SP/AP ratio.
- Two pediatric MD patients experienced prolonged vertigo and underwent surgery.
- Ipsilateral DEH was observed in 2/3 of pediatric DEH patients, with contralateral in 1/3.
Conclusions:
- Pediatric endolymphatic hydrops disorders present unique clinical characteristics.
- Early identification and characterization are crucial for appropriate management of pediatric MD and DEH.
Abstract:
In order to study the characteristics of pediatric patients (< or = 15 years at onset) with endolymphatic hydrops disorders, we selected 5 patients with Ménière's disease (MD) and 3 patients with delayed endolymphatic hydrops (DEH) from 7418 patients who had visited the Neurotological Clinic of the Toyama Medical and Pharmaceutical University Hospital between 1979 and 1999. Clinical features were characterized as follows: (i) pediatric MD patients were rare, comprising approximately 1.5% of all the 337 MD patients in the sample; (ii) a fluctuating hearing loss, strong positive response in glycerol test, high SP/AP amplitude ratio in electrocochleography and moderate positive response in furosemide vestibulo-ocular reflex test were recorded; (iii) in 2 of the 5 pediatric MD patients, vertiginous attacks had persisted for a long period and they had undergone surgical procedures (sac operation and vestibular neurectomy); and (iv) the ipsilateral type of DEH was observed in 2/3 children, and contralateral DEH in 1/3.