BMJ Clin Evid
2015[Nov]; 2015
(?): ? PMID26545070
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INTRODUCTION: Menière's disease causes feelings of fullness or pressure in the
ear, hearing loss, tinnitus, and recurrent bouts of vertigo, and mainly affects
people aged 30-60 years. Menière's disease is at first progressive but
fluctuating, and episodes can occur in clusters. Vertigo usually resolves
eventually, but the hearing deteriorates and the tinnitus and pressure may
persist regardless of treatment. METHODS AND OUTCOMES: We conducted a systematic
overview, aiming to answer the following clinical questions: What are the effects
of combination treatment (betahistine plus thiazide diuretic) to prevent attacks
and delay disease progression of Menière's disease? What are the effects of
intratympanic interventions to prevent attacks and delay disease progression of
Menière's disease? What are the effects of non-drug interventions to prevent
attacks and delay disease progression of Menière's disease? What are the effects
of dietary interventions to prevent attacks and delay disease progression of
Menière's disease? We searched: Medline, Embase, The Cochrane Library, and other
important databases up to July 2014 (Clinical Evidence overviews are updated
periodically; please check our website for the most up-to-date version of this
overview). RESULTS: At this update, searching of electronic databases retrieved
200 studies. After deduplication and removal of conference abstracts, 151 records
were screened for inclusion in the overview. Appraisal of titles and abstracts
led to the exclusion of 100 studies and the further review of 51 full
publications. Of the 51 full articles evaluated, five systematic reviews and four
RCTs were added at this update. We performed a GRADE evaluation for eight PICO
combinations. CONCLUSIONS: In this systematic overview, we categorised the
efficacy for seven interventions based on information about the effectiveness and
safety of betahistine plus thiazide diuretic, caffeine restriction, intratympanic
corticosteroids, intratympanic gentamicin, psychological support, salt
restriction, and vestibular rehabilitation.
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