{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:36:47Z","timestamp":1768567007225,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Identify clinically important factors associated with conservative treatment response in Meniere's disease and incorporate these factors into a composite clinical severity staging system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients newly diagnosed with Meniere's disease between January 1, 2016 and December 31, 2019 were eligible. Patients with previous treatment for Meniere's disease, prior otologic surgery, or a lack of follow\u2010up data were excluded. Treatment\u2010responsive patients were managed with only conservative therapies (eg, dietary modifications, diuretics) and unresponsive patients underwent more intensive therapies (eg, intratympanic procedures, surgical interventions).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 78 patients included in the study, 49 (63%) were responsive to conservative therapies and 29 (37%) were not. Responsive patients had higher proportions of no or mild vertigo (24%, 95% confidence interval [CI]: 3.1%\u201345.8%) and none or mild comorbidity (27%, 95% CI: 9.2%\u201344.7%) and a lower proportion of hearing loss (19%, 95% CI: 5.6%\u201332.4%) compared to unresponsive patients. Conjunctive consolidation of these 3 factors was performed to develop a three\u2010stage system with a treatment response gradient ranging from 100% to 64% to 18% for stage 1 (n\u2009=\u200911), stage 2 (n\u2009=\u200956), and stage 3 (n\u2009=\u200911), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study identified decreased vertigo severity, reduced comorbidity burden, and absence of hearing loss as factors associated with conservative treatment response in Meniere's disease. A composite clinical severity staging system including these 3 factors can be used to optimize treatment selection and promote patient\u2010centered management of Meniere's disease.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.486","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T07:01:49Z","timestamp":1692946909000},"page":"212-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Identifying Predictors of Treatment Response in Meniere's Disease: A Clinical Severity Staging System"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0085-7958","authenticated-orcid":false,"given":"Brevin J.","family":"Miller","sequence":"first","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine in St. Louis  St. Louis Missouri USA"},{"name":"University of Missouri\u2010Kansas City School of Medicine  Kansas City Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5365-0988","authenticated-orcid":false,"given":"Dorina","family":"Kallogjeri","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7971-377X","authenticated-orcid":false,"given":"Matthew A.","family":"Shew","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Division of Otology\/Neurotology Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay F.","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology\u2013Head and Neck Surgery Washington University School of Medicine in St. Louis  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","unstructured":"SchaafH.M\u00e9ni\u00e8re's Disease: vertigo\u2010Hearing Loss\u2010Tinnitus: a Psychosomatically Oriented Presentation. 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