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J Korean Bal Soc > Volume 7(2); 2008 > Article
Journal of the Korean Balance Society 2008;7(2): 174-181.
한국에서 메니에르병의 치료 방침에 대한 다기관 연구
, , , , , , , , , , , , , 구자원, 홍성광, 고의경2, 김규성3, 박경호4, 박홍주5, 안성기, 안중호, 이원상, 임기정, 정재윤, 정원호, 한규철, 채성원
분당서울대학교병원 이비인후과1, 부산대학교병원 이비인후과2, 인하대학교병원 이비인후과3, 가톨릭대학교 강남성모병원 이비인후과4, 건국대학교병원 이비인후과5, 경상대학교병원 이비인후과6, 울산대학교 서울아산병원 이비인후과7, 연세대학교세브란스병원 이비인후과8,
Multicenter study on the treatment pattern of Ménière’s disease in Korea
Sung Kwang Hong, Eui Kyung Koh, Kyu Sung Kim, Kyoung Ho Park, Hong Ju Park, Seong Ki Ahn, Joong Ho Ahn, Won Sang Lee, Gi Jung Im, Jae Yun Jung, Won Ho Chung, Gyu Cheol Han, Sung Won Chae, Ja Won Koo
1Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea. jwkoo99@snu.ac.kr
2Department of Otorhinolaryngology, Pusan National University Hospital, Busan, Korea.
3Department of Otorhinolaryngology, Inha University Hospital, Incheon, Korea.
4Department of Otorhinolaryngology, Catholic University, Kangnam St. Mary's Hospital, Seoul, Korea.
5Department of Otorhinolaryngology, Konkuk University Hospital, Seoul, Korea.
6Department of Otorhinolaryngology, Gyeongsang National University Hospital, Gyeongsangnam-do, Korea.
7Department of Otorhinolaryngology, Ulsan University, Asan Medical Center, Seoul, Korea.
8Department of Otorhinolaryngology, Yonsei University, Severance Hospital, Seoul, Korea.
9Department of Otorhinolaryngology, Korea University, Anam Hospital, Seoul, Korea.
10Department of Otorhinolaryngology, Dankook University Hospital, Chungcheongnam-do, Korea.
11Department of Otorhinolaryngology, Sungkyunkwan University, Samsung Seoul Hospital, Seoul, Korea.
12Department of Otorhinolaryngology, Gachon University, Gil Hospital, Incheon, Korea.
13Department of Otorhinolaryngology, Korea University, Guro Hospital, Seoul, Korea.
14Research center for Sensory Organs, Medical research Center, Seoul National University, Seoul, Korea.
ABSTRACT
Background and Objectives:   It is hard to determine the efficacy of several treatment options of Ménière’s disease since dynamic course of the disease and diverse rate of recurrence. Few modalities are regarded as ‘effective’ in the viewpoint of evidence based medicine. Study was conducted to know the current status of treatment options for Ménière’s disease.
Materials and Methods:  
A multicenter survey was conducted using questionnaires to collect information on current status of treatment patterns in Ménière’s disease. The questionnaire answered by neurotologic surgeons working at 12 institutes in Korea was analyzed.
Results:  
Low salt diet was always instructed to their patients, but 8 out of 12 responders (67%) did not emphasis on the amount of dietary salt. Duration of pharmacotherapy was ranged from 3 to 12 months. Intratympanic steroid injection was performed in 8 institutes (67%). Every institute agreed on the role of intratympanic gentamicin application. Treatment options for intractable patients were asked. Endolymphatic sac surgery, intratympanic steroid, Meniette device and intratympanic aminoglycoside injection were answered in patients who hope to preserve residual hearing. On the contrary, in patients without serviceable hearing, intratympanic jnjection of aminoglycosides (9/12, 75%) dominated as the next treatment option.
Conclusions:  
Most institutes provide similar patterns of practice in medical treatment. The application of intratympanic aminoglycoside is also agreed in intractable patients without serviceable hearing. However, thoughts about the role and detailed methods of the surgical and adjunctive treatment options were not agreed, especially in intractable patients with good hearing. Further clinical studies and discussions would be necessary to provide consensus for the best treatment of Ménière’s disease in Korea. Key words : Ménière’s disease, Pharmacotherapy, Surgery, Aminoglycosides
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