{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T08:56:14Z","timestamp":1785488174583,"version":"3.56.0"},"reference-count":66,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002046","name":"Hearing Health Foundation","doi-asserted-by":"publisher","award":["NIH K23 DC018302"],"award-info":[{"award-number":["NIH K23 DC018302"]}],"id":[{"id":"10.13039\/100002046","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This narrative review examines how speculative belief that the autonomic nervous system causes Meniere's Disease (MD) led otolaryngologists to adopt invasive surgical procedures and medical treatments still offered today.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Google Scholar, PubMed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>A comprehensive literature review (1860\u20132022) was performed using the terms \u201cMeniere AND (sympathetic OR sympathectomy OR vasomotor OR cervical ganglion),\u201d returning 5360 items. All abstracts were briefly reviewed, relevant publications selected for further study, and key articles discussed by all authors. As it became clear that betahistine was related to the historical narrative, an additional search was performed using \u201cBetahistine AND Meniere AND (vasomotor OR sympathetic OR sympathectomy OR cervical ganglion OR autonomic),\u201d which yielded 336 results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the 19th and 20th centuries, growing knowledge of human anatomy led the scientific community to speculate that autonomic dysregulation caused many medical conditions. Excessive sympathetic mediated vasomotor changes were thought to cause hypertension, ischemia, and tissue damage. Clinicians applied the hypothesis to MD, assigning the sympathetic nervous system responsible for vertigo secondary to paroxysmal vasospasm and for hearing loss to poor cochlear nutrition. Despite limited animal experiments and isolated clinical observations, otolaryngologists performed sympathectomies, and, in the 1970s, replaced the procedure with betahistine as an alternative medical treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Premature excitement about a plausible hypothesis led to unnecessary and unwarranted operations. Despite absent evidence of sympathetic overactivation in MD, surgeons eagerly adopted sympathectomies, and later betahistine. Rigorous evaluation of the validity of these treatment practices is needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>5 <jats:italic>Laryngoscope<\/jats:italic>, 134:535\u2013542, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30944","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T05:43:34Z","timestamp":1692423814000},"page":"535-542","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Historical Therapies for Suspected Autonomic Dysregulation in Meniere's Disease"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3935-6157","authenticated-orcid":false,"given":"Diane","family":"Jung","sequence":"first","affiliation":[{"name":"Johns Hopkins School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianela","family":"Perdomo","sequence":"additional","affiliation":[{"name":"Johns Hopkins School of Medicine  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan K.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Johns Hopkins University  Baltimore Maryland U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"issue":"8","key":"e_1_2_6_2_1","first-page":"16","article-title":"Sur une forme de surdit\u00e9 grave d\u00e9pendant d'une l\u00e9sion de l'oreille interne","volume":"26","author":"Meni\u00e8re P","year":"1861","journal-title":"Bull Acad Nat Med"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016482909119208"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3679.54"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016484709124231"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-003-1103-5"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/003591572802101234"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000517452"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1973.00780010403008"},{"key":"e_1_2_6_11_1","volume-title":"Du Traitement de l'otorrh\u00e9e Purulente Chronique. 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