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Otology/Neurotology

(243) Identifying Predictors of Treatment Response in Meniere's Disease

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time

    Presenting Author(s)

  • BM

    Brevin Joseph Miller, Other

    T32 Predoctoral Clinical Research Scholar
    Washington University School of Medicine in St. Louis
    St. Louis, Missouri, United States

    • Co-Author(s)

  • DK

    Dorina Kallogjeri, MD, MPH

    Assistant Professor
    Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine
    St Louis, Missouri, USA

    • Senior Author(s)

  • Jay F. Piccirillo, MD

    Professor, Vice Chair for Research
    Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine
    St. Louis, MO, United States

Disclosure(s):
Brevin Joseph Miller, Other: No relevant relationships to disclose.


Introduction: Meniere’s disease (MD) is an inner ear disorder which negatively affects quality of life. This study aims to identify predictors of response to conservative therapies in patients with MD.

Methods: This is a nested case-control study of patients newly diagnosed with MD in 2016-2019 at a tertiary medical center. Included patients were adults without previous treatment for MD. Cases were patients responsive to conservative therapies (CT) defined as disease managed using only nonpharmacologic therapies (e.g., sodium restriction) or oral medications (e.g., diuretics). Controls were patients non-responsive to CT who were recommended intratympanic therapies or surgical interventions.

Results: Of 79 included patients, 50 (63%) responded to CT. Patients with no or mild comorbidity burden (CB) (n = 67) had 7.22 times higher odds (95% CI: 1.57 to 33.2) of responding to CT compared to patients with moderate or severe CB (n = 12). Patients with no or mild vertigo (n = 35) had 2.65 times higher odds (95% CI 0.77 to 9.21) of responding to CT compared to patients with severe vertigo (n = 20). Patients presenting with no subjective hearing loss (HL) (n = 12) had 9.45 times higher odds (95% CI: 0.913 to 97.9) of responding to CT compared to those with subjective HL (n = 67). No association was found between response to CT and age, sex, race, and presence of tinnitus or aural fullness. Risk stratification of patients using conjunctive consolidation showed that all patients (100%) with no or mild CB and no HL (n = 11) responded to CT. Patients with no or mild CB and HL (n = 56) had a CT response rate of 65%. The lowest response rate was observed in those with moderate or severe CB regardless of HL presence with only 3 (25%) of 12 patients responding to CT.

Conclusions: Comorbidity burden, vertigo severity, and presence of hearing loss were associated with conservative therapy response in Meniere’s disease. These clinically meaningful factors are easily obtained and may be used to guide expectations of treatment response and promote patient-centered treatment selection to optimize MD management.