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Intervention Outcomes for Meniere's Disease: An Umbrella Review
Warren B Chun1, Shaun A Nguyen1, John F Mills1
1Medical University of South Carolina, Department of Otolaryngology-Head & Neck Surgery, Charleston, South Carolina, USA.
The Laryngoscope
|July 8, 2026
Summary
Intratympanic gentamicin offers the best vertigo control for Meniere
Area of Science:
- Otolaryngology
- Neurology
- Pharmacology
Background:
- Meniere's disease is a chronic inner ear disorder characterized by vertigo, tinnitus, and hearing loss.
- Effective management strategies are crucial for improving patient quality of life.
- Systematic reviews and meta-analyses provide valuable insights into treatment efficacy.
Purpose of the Study:
- To systematically review and summarize evidence on pharmacologic, device-based, and surgical interventions for Meniere's disease.
- To assess the outcomes of these interventions, including vertigo control, tinnitus improvement, and adverse events.
Main Methods:
- Searched CINAHL, Cochrane, PubMed, and Scopus for systematic reviews and meta-analyses.
- Included 22 reviews assessing interventions such as gentamicin, corticosteroids, betahistine, positive pressure therapy, acupuncture, endolymphatic sac decompression, and cochlear implantation.
- Extracted data and pooled results using a random-effects model where possible, adhering to PRISMA 2020 and Cochrane Handbook guidelines.
Main Results:
- Intratympanic gentamicin demonstrated the highest vertigo control (89%) but posed risks of hearing loss.
- Intratympanic steroids provided moderate benefits with fewer auditory risks; positive pressure therapy yielded mixed results.
- Endolymphatic sac decompression showed initial high efficacy (75%-82%) that declined; cochlear implants improved speech and tinnitus in severe cases.
Conclusions:
- Intratympanic gentamicin offers strong vertigo control but is supported by low-quality evidence and hearing risks.
- Conservative treatments like intratympanic steroids and betahistine show modest, mixed benefits.
- Surgical and device interventions vary in effectiveness, emphasizing the need for personalized, symptom-driven care and high-quality trials.
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