{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:59:24Z","timestamp":1790067564971,"version":"4.0.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Meniere\u2019s disease remains a poorly understood inner ear disorder since its first description by Prosper Meniere in the early 1800s. Characterized by episodic vertigo, fluctuating hearing loss, and tinnitus, it continues to challenge clinicians due to its unpredictable course and variable treatment response. Lifestyle modification alone often fails to adequately control vertigo episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim and Objectives:<\/jats:title>\n                    <jats:p>To assess the effectiveness of oral pharmacotherapy in controlling vertigo and stabilizing hearing in patients with Meniere\u2019s disease, and to develop a practical, non-invasive treatment protocol suitable for routine clinical use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients diagnosed with Meniere\u2019s disease as per 1995 AAO-HNS criteria were managed with standard lifestyle advice followed by oral pharmacotherapy, including an antihistaminic agent (betahistine) and a combination of diuretics (furosemide and spironolactone). Treatment response was evaluated based on vertigo control, reduction in episode frequency, and stabilization of audiometric thresholds. Surgical options were considered only for patients with persistent, disabling vertigo despite maximal medical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Lifestyle measures alone did not provide adequate vertigo control. In contrast, combined oral pharmacotherapy resulted in marked improvement, with significant reduction in vertigo frequency and satisfactory stabilization of hearing levels. Only a small proportion of patients required evaluation for surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A regimen combining betahistine with diuretics offers a reliable, non-invasive, and effective approach to managing Meniere\u2019s disease. This protocol provides substantial vertigo control and hearing stabilization, and may be adopted as a first-line strategy before considering surgical options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_340_25","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:00:10Z","timestamp":1780984810000},"page":"1582-1588","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Vertigo-unsolved Mystery (Meniere\u2019s Disease) Care Redefined: Insights from a Tertiary Care Center"],"prefix":"10.4103","volume":"25","author":[{"given":"Arti","family":"Rajpoot","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajat","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Bahadur","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerendra","family":"Verma","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head-Neck Surgery, King George\u2019s Medical University, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"R2-20260922","first-page":"160","article-title":"Impaired carbohydrate metabolism and idiopathic Meniere's disease","volume":"56","author":"Updegraff","year":"1977","journal-title":"Ear Nose Throat J"},{"key":"R3-20260922","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1080\/00016480310000728a","article-title":"Radical scavengers for M\u00e9ni\u00e8re's disease after failure of conventional therapy: A pilot study","volume":"123","author":"Takumida","year":"2003","journal-title":"Acta Otolaryngol"},{"key":"R4-20260922","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3109\/00016489509125240","article-title":"Clinical survey of Meni\u00e9re's disease: 574 cases","volume":"520","author":"Haid","year":"1995","journal-title":"Acta Otolaryngol Suppl"},{"key":"R6-20260922","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1177\/000348948309200212","article-title":"Diagnostic significance of transtympanic electrocochleography in Meni\u00e8re's disease","volume":"92","author":"Gibson","year":"1983","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"R7-20260922","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.bjorl.2016.04.021","article-title":"Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of M\u00e9ni\u00e8re's disease","volume":"83","author":"Lamounier","year":"2017","journal-title":"Braz J Otorhinolaryngol"},{"key":"R8-20260922","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1097\/00005537-199807000-00008","article-title":"Use of electrocochleography in the diagnosis of Meniere's disease","volume":"108","author":"Levine","year":"1998","journal-title":"Laryngoscope"},{"key":"R9-20260922","first-page":"235","article-title":"Clinical significance of SP\/AP ratio in inner ear diseases","volume":"51","author":"Ohashi","year":"1989","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"key":"R10-20260922","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/0196-0709(93)90006-S","article-title":"Summating-potential\/action-potential ratio in normal ears: Effects of dehydration","volume":"14","author":"Ridenour","year":"1993","journal-title":"Am J Otolaryngol"},{"key":"R11-20260922","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1288\/00005537-199101000-00009","article-title":"Monothermal differential caloric testing in patients with Meni\u00e8re's disease","volume":"101","author":"Wexler","year":"1991","journal-title":"Laryngoscope"},{"key":"R12-20260922","doi-asserted-by":"crossref","first-page":"e162","DOI":"10.1097\/AUD.0000000000000041","article-title":"Prevalence, associated factors, and comorbid conditions for M\u00e9ni\u00e8re's disease","volume":"35","author":"Tyrrell","year":"2014","journal-title":"Ear Hear"},{"key":"R13-20260922","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1097\/00005537-200208000-00029","article-title":"Intermittent pressure therapy of intractable M\u00e9ni\u00e8re's disease using the Meniett device: A preliminary report","volume":"112","author":"Gates","year":"2002","journal-title":"Laryngoscope"},{"key":"R14-20260922","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.otc.2010.05.003","article-title":"Clinical hints and precipitating factors in patients suffering from Meniere's disease","volume":"43","author":"Rauch","year":"2010","journal-title":"Otolaryngol Clin North Am"},{"key":"R15-20260922","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s11940-015-0341-x","article-title":"Treatment of Meni\u00e8re's disease","volume":"17","author":"Sharon","year":"2015","journal-title":"Curr Treat Options Neurol"},{"key":"R16-20260922","first-page":"429","article-title":"Betahistine in the treatment of M\u00e9ni\u00e8re's disease","volume":"3","author":"Lacour","year":"2007","journal-title":"Neuropsychiatr Dis Treat"},{"key":"R17-20260922","doi-asserted-by":"crossref","first-page":"68","DOI":"10.22502\/jlmc.v4i2.93","article-title":"First line treatment of Meniere's disease","volume":"4","author":"Acharya","year":"2016","journal-title":"J Lumbini Med Coll"},{"key":"R19-20260922","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1001\/archotol.1981.00790410009002","article-title":"Placebo effect in surgery for Meniere's disease: a double-blind, placebo-controlled study on endolymphatic sac shunt surgery","volume":"107","author":"Thomsen","year":"1981","journal-title":"Archives of Otolaryngology"},{"key":"R20-20260922","doi-asserted-by":"crossref","first-page":"F1127","DOI":"10.1152\/ajprenal.00387.2003","article-title":"Glucocorticoids stimulate cation absorption by semicircular canal duct epithelium via epithelial sodium channel","volume":"286","author":"Pondugula","year":"2004","journal-title":"Am J Physiol Renal Physiol"},{"key":"R21-20260922","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/mao.0b013e31815dbafc","article-title":"Longitudinal results with intratympanic dexamethasone in the treatment of M\u00e9ni\u00e8re's disease","volume":"29","author":"Boleas-Aguirre","year":"2008","journal-title":"Otol Neurotol"},{"key":"R22-20260922","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1080\/00016480701762458","article-title":"Intratympanic gentamicin therapy for control of vertigo in unilateral Meniere's disease: a prospective, double-blind, randomized, placebo-controlled trial","volume":"128","author":"Postema","year":"2008","journal-title":"Acta oto-laryngologica"},{"key":"R23-20260922","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1097\/00005537-200305000-00009","article-title":"Long-term hearing outcome in patients receiving intratympanic gentamicin for M\u00e9ni\u00e8re's disease","volume":"113","author":"Wu","year":"2003","journal-title":"Laryngoscope"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_340_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T08:00:24Z","timestamp":1790064024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_340_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_340_25","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"2025-07-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}