Oscé Hanne, Loos Elke, Huygen Annelien, Desloovere Christian
Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
Department of Neurosciences, Research Group ExpORL, KU Leuven, University of Leuven, Leuven, Belgium.
Eur Arch Otorhinolaryngol. 2025 Apr 9. doi: 10.1007/s00405-025-09329-5.
The management of unilateral Menière's disease (MD) in adult patients remains contentious, with various therapeutic options proposed but no established gold standard. This scoping review aims to evaluate the current treatment options for unilateral MD, identifying challenges in management and providing guidance for ENT physicians in selecting effective therapies.
A comprehensive literature search of the MEDLINE and Embase databases was conducted without date restrictions, assessing various treatment modalities for MD. Randomized controlled trials (RCTs) were selected to ensure the highest quality of evidence was reviewed.
Thirty-four RCTs met the inclusion criteria. The current evidence base encompasses dietary interventions, systemic drug therapy, intratympanic treatments, positive pressure therapy, low-level laser therapy, and non-destructive surgical techniques. However, the evidence supporting these treatments is limited and inconsistent. Notably, none of the RCTs considered the heterogeneity of MD patient populations, which may explain the variability in study results.
This review highlights the limited evidence supporting current treatments for unilateral MD, emphasizing the need for high-quality, placebo-controlled trials. Future research should incorporate biomarker-based stratification, large patient cohorts, standardized outcome measures, and long follow-up periods to enhance the consistency and comparability of findings.
成人单侧梅尼埃病（MD）的治疗仍存在争议，虽有多种治疗方案被提出，但尚无公认的金标准。本综述旨在评估单侧MD的当前治疗选择，识别管理中的挑战，并为耳鼻喉科医生选择有效治疗方法提供指导。
对MEDLINE和Embase数据库进行全面的文献检索，无日期限制，评估MD的各种治疗方式。选择随机对照试验（RCT）以确保审查最高质量的证据。
34项RCT符合纳入标准。当前的证据基础包括饮食干预、全身药物治疗、鼓室内治疗、正压治疗、低强度激光治疗和非破坏性手术技术。然而，支持这些治疗的证据有限且不一致。值得注意的是，没有一项RCT考虑到MD患者群体的异质性，这可能解释了研究结果的差异。
本综述强调了支持当前单侧MD治疗的证据有限，强调需要高质量的、安慰剂对照试验。未来的研究应纳入基于生物标志物的分层、大型患者队列、标准化结局测量和长期随访期，以提高研究结果的一致性和可比性。
