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Otology/Neurotology

(476) Temporal Trends in Meniere's Disease Diagnosis and Treatment

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Tyler J. Gallagher, BS, BA

    Medical Student
    Keck School of Medicine of the University of Southern California
    MONTEREY PARK, California, United States

    • Co-Author(s)

  • Meredith E. Adams, MD MS

    Associate Professor
    University of Minnesota
    Minneapolis, MN, United States

    • Senior Author(s)

  • Janet S. Choi, MD MPH

    Fellow Physician
    2University of Minnesota Department of Otolaryngology-Head and Neck Surgery, Minneapolis, MN
    Minneapolis, MN, USA

Disclosure(s):
Tyler J. Gallagher, BS, BA: No relevant relationships to disclose.


Introduction: Management approaches for Meniere’s disease (MD) have changed significantly over time. This study investigated management practices of MD and its temporal trends from 2008-2022 based on the TriNetX network.

Methods: Study cohort included patients (≥18 years) with MD diagnosis between 2008-2022 from TriNetX, a multinational network of EMR data primarily from the US (>87% annually). ICD-10, CPT, and RXNorm codes were used to create an MD cohort and quantify rates of treatments per new (within 12 months) and any diagnosis of MD. Temporal trends were analyzed via joinpoint regression.

Results: Our cohort included 71,465 adults with MD diagnosis (age, mean [SD]: 64[14]). During 2020-2022, 164.8/10,000 MD diagnosis received intratympanic injection (steroid and gentamicin), 61.9/10,000 received endolymphatic sac surgery and 20.8/10,000 received labyrinthectomy. When examining temporal trends, there was significant increase in rates of medications prescribed within 12 months of MD diagnosis after 2020; Annual Percent Change (APC) for diuretics increased from 5.8 [95%CI: 2.7-9.0] 2013-2020 to 41.5 [25.6-59.4] 2020-2022, antihistamines increased from 4.4 [2.5-6.3] 2008-2020 to 35.6 [16.0-58.4] 2020-2022, and benzodiazepine increased from 3.1 [1.0-5.2] 2008-2020 to 44.5 [22.0-71.2] 2020-2022. The APC of intratympanic injection within 12 months of MD diagnosis increased from 8.9 [1.4-17.1] 2008-2020 to 104.5 [37.6-203.9] 2020-2022. Rate of endolymphatic sac surgery and labyrinthectomy for any patients with MD diagnosis gradually decreased from 2008-2022 (APC -9.5 [-12.9 to -5.9] and APC -10.2 [-13.8 to -6.5], respectively, without significant joinpoints.

Conclusions: In this cohort, use of medical management and intratympanic injection has significantly increased since 2020 and use of surgical treatments has decreased over recent years. Data limitations include potential unpublished variation in cohort composition over time. While heterogeneity in management of MD continues, our findings demonstrate a potential impact of the COVID pandemic and new clinical guidelines.