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Management of drop attacks in Ménière’s disease: a systematic literature review

Published online by Cambridge University Press:  21 October 2024

Anya Selwyn Open the ORCID record for Anya Selwyn [Opens in a new window]  and
Iain Mckay-Davies
Anya Selwyn*
Affiliation:
Maidstone and Tunbridge Wells NHS Trust, Kent, England, UK
Iain Mckay-Davies
Affiliation:
Maidstone and Tunbridge Wells NHS Trust, Kent, England, UK
*
Corresponding author: Anya Selwyn; Email: [email protected]
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Abstract

Objectives

Drop attacks are described as an instantaneous fall to the ground, occurring without warning and without loss of consciousness, a consequence of abrupt deformation of the otolithic membrane due to high endolymphatic pressure. Drop attacks present significant injury risk, therefore effective treatment is imperative. This review is the first to examine all evidence for the management of drop attacks in Ménière’s disease, and make recommendations.

Methods

We conducted a systematic literature review. Inclusion criteria consisted of all published English language examining treatments of drop attacks in Ménière’s disease.

Results

One hundred and five articles were identified, 19 met criteria (case series and/or cohort studies). Two articles identified conservative treatments, eight examined intratympanic gentamicin, seven examined surgery, one examined all three and one examined intratympanic dexamethasone.

Conclusion

Evidence for the management of drop attacks in Ménière’s disease is limited due to small studies. Some surgical approaches have limited effect. Intratympanic dexamethasone remains a promising treatment; further research is recommended.

Keywords

Meniere diseaseendolymphatic hydropsdrop attacksyncopal vertigo
Type
Review Article
Information
The Journal of Laryngology & Otology , First View , pp. 1 - 7
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Anya Selwyn takes responsibility for the integrity of the content of the paper. This paper was presented at the The 7TH Congress of the Confederation of European ORL-HNS 2024

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