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Updated: May 23, 2025
04:11
Endolymphatic Duct Blockage as a Surgical Treatment Option for Ménière's Disease
Published on: April 28, 2023
1.1K
Long-Term Risk of Progression From Unilateral to Bilateral Méniere's Disease: A Systematic Review and Meta-Analysis
Thomas James Hudson1, Linette Shu Hwei Tan1, Veronica Phillips2
1Department of Otolaryngology-Head and Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Summary
There is a 13% risk of developing bilateral Ménière
Area of Science:
- Otolaryngology
- Neurology
- Epidemiology
Background:
- Ménière's disease (MD) is a disorder of the inner ear.
- Unilateral MD can progress to bilateral involvement over time.
- Understanding conversion risk is crucial for patient management.
Purpose of the Study:
- To determine the overall risk of unilateral to bilateral Ménière's disease conversion.
- To identify the time interval from diagnosis to conversion.
- To explore risk factors and audiometric trends associated with conversion.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Inclusion of 11 longitudinal studies on unilateral to bilateral MD progression.
- Random-effects meta-analyses for conversion risk and time, narrative synthesis for other factors.
Main Results:
- Overall conversion risk from unilateral to bilateral MD is 13% (95% CI, 12-15%).
- Mean time to conversion is 8.2 years, with some conversions occurring over 20 years post-diagnosis.
- Potential risk factors include tympanic membrane perforation and baseline hearing loss; first-sided ear surgery may be protective.
Conclusions:
- A significant risk of conversion to bilateral Ménière's disease exists.
- This risk necessitates consideration in treatment decisions, even years after initial diagnosis.
- Further research is needed to clarify risk/protective factors and audiometric patterns.
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