Doença de Ménière
Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- vertigem
- perda auditiva
- zumbido
- plenitude aural
- quedas súbitas
Other diagnostic factors
- teste de Romberg positivo
- teste de passos de Fukuda
- sintomas bilaterais
- nistagmo
- marcha em tandem
Risk factors
- infecção viral recente
- predisposição genética
- doença autoimune
- idade mais avançada
Diagnostic tests
1st tests to order
- condução óssea e aérea de tons puros com mascaramento
- audiometria da fala
- timpanometria/imitanciometria/níveis do reflexo do estapédio
- emissões otoacústicas (EOA)
Tests to consider
- eletrococleografia
- eletronistagmografia
- teste da cadeira rotatória
- potencial evocado miogênico vestibular (PEMV)
- ressonância nuclear magnética (RNM) dos canais auditivos internos
- testes da função tireoidiana
- doença de Lyme e sorologia para sífilis
- anticorpo antinuclear
- anticorpo anticitoplasma de neutrófilo
- fator reumatoide
Emerging tests
- RNM tridimensional
Treatment algorithm
todos os pacientes
perda auditiva persistente
falha das terapias medicamentosa e intratimpânica; audição adequada
falha das terapias medicamentosa e intratimpânica; audição gravemente prejudicada
Contributors
Authors
Soha N. Ghossaini, MD, FACS
Otology-Neurotology
Ear Nose and Throat Associates of New York
New York
NY
Disclosures
SNG declares that she has no competing interests.
Acknowledgements
Dr Ghossaini would like to gratefully acknowledge the late Professor Maurice H. Miller, a previous contributor to this topic. MHM declared that he had no competing interests.
Peer reviewers
Steven D. Rauch, MD
Associate Professor of Otology and Laryngology
Harvard Medical School
Boston
MA
Disclosures
SDR declares that he has no competing interests.
Christopher J. Linstrom, MD
Professor
Otolaryngology/Head and Neck Surgery
The New York Eye and Ear Infirmary
Surgeon Director
New York
NY
Disclosures
CJL declares that he has no competing interests.
Peter Rea, MA, BM BCh, FRCS(ORL-HNS)
Consultant ENT Surgeon
Leicester Royal Infirmary
Leicester
UK
Disclosures
PR declares that he has no competing interests.
Doris Eva Bamiou, MD, MSc, PhD
Clinical Senior Lecturer & Consultant in Audiovestibular Medicine
Ear Institute
University College London
London
UK
Disclosures
DEB declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Goebel JA. 2015 Equilibrium Committee Amendment to the 1995 AAO-HNS guidelines for the definition of Ménière's disease. Otolaryngol Head Neck Surg. 2016 Mar;154(3):403-4. Abstract
Basura GJ, Adams ME, Monfared A, et al. Clinical practice guideline: Ménière's disease. Otolaryngol Head Neck Surg. 2020 Apr;162(suppl 2):S1-55.Full text Abstract
Lopez-Escamez JA, Carey J, Chung WH, et al; Classification Committee of the Barany Society; Japan Society for Equilibrium Research; European Academy of Otology and Neurotology (EAONO); Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS); Korean Balance Society. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Neuroma acústico
- Enxaqueca vestibular (também chamada de tontura associada à enxaqueca e vertigem associada à enxaqueca)
- Neuronite vestibular
More DifferentialsGuidelines
- Hearing loss in adults: assessment and management
- Clinical practice guideline: Ménière's disease
More GuidelinesPatient information
Zumbido
Doença de Ménière
More Patient information
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer