Associations Among Medical Therapy, SelfAdministered Exercise, and Characteristics of Ménière's Disease.

BACKGROUND: The aim of the current study was to explore the associations among different therapeutic procedures, self-administered exercise, and characteristics of Ménière's disease. METHODS: The study used a retrospective design and included 539 people with Ménière's disease who were focusing on self-administered exercise. The mean age and history of Ménière's disease among these participants were 61.9 years and 15.6 years, respectively. Of the participants, 79.5% were female. The data were collected by an electronic questionnaire that focused on symptoms of Ménière's disease, exercise and training habits, balance problems, impacts of the complaints, quality of life, medical treatment, physiotherapy, and psychotherapy. RESULTS: Of the participants, 79.3% used medical treatment. Betahistine (56.8%) was the most popular followed by periodical anti-emetic use (41.0%) and diuretics (22.4%). Of the participants 70% were doing some self-administered training. The frequency of training depended on age, severity of balance problems, vestibular drop attacks, and gait problems. The type of training depended on age, quality of life, vestibular drop attacks, and gait problems. No association was found between vertigo and frequency/type of balance training. CONCLUSION: The use or effect of therapeutic procedures for Ménière's disease patients was not related to symptoms experienced. Most participants with Ménière's disease used training programs that aimed to alleviate their condition, especially balance-, gait-, and vestibular drop attack-associated problems. Patient support organizations should be working to help characterize the types of balance disorders people are dealing with in order to individually tailor a rehabilitation program to the patient's needs.

Adverse COVID-19 vaccination effects in Finnish patients with Ménière's disease: a cross-sectional study.

Background: The association between reporting adverse coronavirus disease 2019 (COVID-19) vaccination effects and those with a history of audiovestibular difficulties is unknown. The aim of this research is therefore to investigate adverse vaccination effects in adults with a history of Ménière's disease. Specifically, the incidence of adverse effects, the factors associated with those reporting adverse effects and the relationship between the reporting of audiovestibular and other adverse effects. Methods: A mixed-methods exploratory cross-sectional survey study design was used. Data were collected from 333 members of the Finnish Ménière Association. The survey was designed to obtain demographic information that may be associated with having adverse effects or not, vaccination-specific information and adverse vaccination effects. Both health and audiovestibular adverse events were identified. Data analysis included comparing those reporting and not reporting adverse vaccination effects. Results: The mean age was 63 years with 81% being female. Of the 327 respondents who had one of the COVID-19 vaccinations (Comirnatry/ Pfizer, Astra Zeneca, or Moderna), 203 (62%) reported no adverse effects. The type of or number of vaccinations were not related to the reporting of adverse effects. The most frequently reported adverse effects were injection site tenderness (38%), arm pain (21%), fever (15%) and headaches (15%). Post-vaccination tinnitus and vertigo (both 7%) were the most frequently reported audiovestibular-related symptoms, followed by aural fullness (6%) and hearing loss (4%). Those reporting previous pre-vaccination vertigo were more likely to have post-vaccination vertigo. The presence of post-vaccination tinnitus, hearing loss, and aural fullness, predicted the presence of post-vaccination vertigo. Conclusions: A small proportion of patients with a history of Ménière's disease may experience adverse post-vaccination effects. Further research is required to explore whether adverse post-vaccination audiovestibular effects are more prevalent in those with a history of otological disorders compared with the general population.

Does the Self-training in Ménière's Disease Fit the Disease Characteristics and Help Alleviate the Balance Problems?

BACKGROUND: To examine whether the self-initiated exercise in Ménière's disease fits the characteristics of the balance problems. METHODS: This retrospective study included 539 people with Ménière's disease belonging to the Finnish Ménière Federation. The mean age was 61.9 years with a mean history of Ménière's disease of 15.6 years. The data were collected with an online questionnaire. RESULTS: In total, 30% of the patients did not do any training, 23% did training once a week, 22% did 2-3 times a week, and 26% did the training daily. The most common training exercises were different self-training exercises (26%) followed by walking (16%), guided training (15%), viewing plus balance training (10%), and viewing training (4%). Non-defined balance problems (18%) were associated with recent vertigo attacks. Swaying type of balance problems were present in 23% and they used all types of training programs. Rocking type of balance disorder was present in 8% and they preferred guided training exercises. Tripping off type of balance disorder was present in 25% and they preferred viewing plus balance training. CONCLUSIONS: The type of self-training used was related to the type of balance problems reported. When choosing the vestibular rehabilitation in Ménière's disease , the type of balance disorder should be characterized and the rehabilitation program should be individually tailored.

Characterization of Balance Problems and Rehabilitation Needs of Patients with Ménière's Disease.

BACKGROUND: To explore and characterize balance problems in subjects with Ménière's disease (MD). METHODS: A total of 539 people with MD with a mean age of 61.9 years, mean disease history of 15.6 years, and 79.5% females were recruited. The online questionnaire, consisting of 39 questions, including both structured and open-ended questions, focused on symptoms of MD, balance problems, impacts of the complaints, and quality of life (QoL). RESULTS: After hearing loss (58%) and tinnitus (50%), balance problems (44%) were among the most commonly reported MD complaints, even higher than the impact of vertigo (40%). However, only 22% reported that those balance problems made obvious impacts in their daily lives. The most common balance problem that significantly reduced QoL was tripping (34%). Swaying (25%) had a limited impact on QoL, whereas rocking (10%) was less common but caused a significant impact on QoL. Non-defined balance problems were reported at 18%; these were occasional and correlated with vertigo attacks. Older participants had more frequent tripping problems. Younger participants more frequently reported swaying and rocking. CONCLUSIONS: Risk factors predicting poor postural control were mostly related to complaints reflecting otolith pathology. Different types of postural problems require different strategies to manage balance control and cope with the disease.

Vestibular drop attacks in Ménière's disease.

The aim of the present study was to evaluate the severity of vestibular drop attack (VDA) in Ménière's disease (MD) and to examine the association between VDA severity and other MD-related complaints. The study used a cross-sectional survey design using an electronic questionnaire. The mean age of participants was 56.7 years, and the mean duration of MD was 12.4 years. Four categories of VDA were identified based on level of severity. VDA occurred in 305 (50.7%) of the 602 patients. Of these, 133 patients (22%) experienced mild VDA (i.e., associated with tripping); 80 (13%) experienced moderate VDA (i.e., associated with fall threat unless they had been able to grab support); and 92 (15%) experienced severe VDA (i.e., patients fell to the ground, as in a classical Tumarkin attack). In 70%of participants, VDA occurred less than once a week. VDA lasted for only a few seconds in 90%of participants. 87%reported single attacks, whereas 13%experienced VDA in clusters. VDA was associated with visual auras, reduced quality of life, poor postural control, and fatigue. Approximately half of MD patients experience VDA with varying degrees of severity. If VDA causes falls or near-falls, the attacks should be appropriately treated.

The Use of the Internet and Social Media by Individuals with Ménière's Disease: An Exploratory Survey of Finnish Ménière Federation Members.

OBJECTIVES: The present study explored the use of the Internet and social media by individuals with Ménière's disease (MD). MATERIALS AND METHODS: This study utilized a retrospective design and included the data of 465 individuals with MD from the Finnish Ménière Federation (FMF) database. Moreover, the participants included 346 females (i.e., approximately 75% of the sample), with roughly 95% of which middle-aged or older adults. An Internet-based survey was used to collect the demographic information and determine the use of the Internet and social media by individuals with MD in order to establish a computer-based peer support program. RESULTS: Based on the findings, more than 90% of the respondents reported using the Internet, 70% used the Internet to gather information about MD, and 47% stated that they trusted the information on the Internet. CONCLUSION: The Internet and social media are frequently used by individuals with MD to gather information about their health conditions. Therefore, it is essential to ensure that appropriate and accurate information is available via Internet websites and social media platforms.

Vestibular drop attacks in Ménière's disease and its association with migraine.

PURPOSE: We explored the association of vestibular drop attacks (VDA) with or without migraine in patients with Ménière's disease (MD) and compared with patients classified as vestibular migraine (VM). METHOD: The study involved a cross-sectional survey design. Data were collected from 401 members of Finnish Ménière Federation who experienced VDA. RESULTS: In the sample of 401 patients with VDA who did not experience headache, VM was diagnosed among 16.4% participants and migraine not associated with vertigo was experienced among 25.2% of the participants. Severity of postural instability, ability to move, and ability to stand up from chair differed among VDA baseline, VDA migraine and VM patient groups. Syncope associated with VDA was noticed more frequently in VM group. In terms of neurological complaints, except for visual problems, all other symptoms differed significantly between three patient groups. The health-related quality of life also differed between groups with VM group having the worse scores. CONCLUSIONS: The current study suggests that migraine is common in MD patients who experience VDA. We observed no definite complaint that could be ascertained to VM. The coexistence of migraine increased the impact of complaints associated with VDA.