Abstract | Objective: The aim of this study was to investigate current treatment practices and self-reported effectiveness in Menière's disease. Materials and Methods: Members of two Italian Menière's disease support (n=170) with ≥6-month history of Menière's disease were administered an online survey about recent treatments. Vertigo episode count, work absenteeism, and limitations in family life, social life,work or travel, as included in the Social Life and Work Impact of Dizziness (SWID) Questionnaire before and after recent treatments were queried. Results: Twenty-four different treatments were reported for Menière's disease, with dietary modifications (55%), diuretics (47%), and betahistine (41%) being most common. The majority (71%) received multiple simultaneous treatments. Prior to the most recent treatments 78-89% of respondents indicated limitations in family or social life, work or traveling. After their most recent treatment, respondents reported improvements in mean vertigo episode counts (5.7±7.6 vs. 2.6 ±4.6, p<0.001), days off work per month (10.1 ±9.2 vs. 4.2 ±6.7, p<0.001), and proportions indicating limitations in any functional measure assessed (p<0.05). These findings were consistent regardless of treatment approach (all p<0.05). Intratympanic gentamicin provided the greatest reductions in vertigo count, functional limitations, and work absenteeism (all p<0.01) as well as the fewest respondents reporting post-treatment functional limitations (16-37%). Conclusions: Despite numerous treatment approaches targeting different proposed pathophysiology for Menière's disease in this cross-sectional survey, all treatments are reported as effective by patients. These findings support a prominent placebo effect in Menière's disease and highlight challenges in studying treatment outcomes; there is a critical need to better understand Menière's disease. |
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