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CCSVI in Meniere’s Syndrome: Diagnosis and Treatment

A. Bruno M.D., L. Califano M.D., D. Mastrangelo° M.D., M. De Vizia M.D. ° B. Bernardo° M.D. Dept of Vascular and Endovascular Surgery -GEPOS CLINIC Telese Terme (BN) ITALY - Dept of Audiology and Phoniatrics, G. Rummo Hospital Benevento ITALY

Background: Menière’s Syndrome described in 1861 by Prospero Menière. The disease is characterized by the presence of endolymphatic hydrops in cochlea and labyrinth. Patients report dizziness, hearing loss, fullness, tinnitus and recurrent acute vertigo. Etiology is not sure but many factors could lead to a modified reabsorption of endolymph in the inner ear.

Currently, there is no a therapy for the cure of Meniere’s Disease. Intratympanic gentamycine is an effective procedure to be used in case of frequently relapsing vertigo. Purpose: With the use of ultrasound and phlebography, the authors have evaluated the relationship between Menière’s Syndrome and CCSVI and the effectiveness of angioplasty in the reduction of symptoms.

Materials and Methods: 50 patients affected by Menière’s Syndrome who have had no improvement with medical therapy, underwent echo color Doppler sonografy using Zamboni’s protocol for the diagnosis of CCSVI. 49 were positive for CCSVI. In 20 cases we performed, venography and the diagnosis were confirmed. These patients were treated by PTA of IJV.

Results: Ultrasound diagnosis of CCSVI was performed in patients with Menière’Syndrome with a positivity in 49 patients out 50 examinated (95% of cases). In the healthy population, the presence of CCSVI has been evident in only 3% of cases. In twenty patients venography was performed which confirmed the diagnosis and PTA was effective in all patients.

Conclusions There is a significant prevalence of CCSVI in patients with Menière’S Syndrome and its treatment with PTA has given good results in all patients with reduction of symptoms.

“Venous abnormalities in Meniere Disease”
P.M.Bavera; P. Cecconi; D. Alpini; F. Di Berardino

The presentation will be of approximately 15/20 slides, including title and
conclusions in respect of the assigned timetable.

A brief definition of the Meniere Disease, with principal symptoms

Correlations between these symptoms and those usually present in CCSVI
affected Patients (mainly Multiple Sclerosis Patients)

Most evident and frequent results in Meniere Disease compared with those with
over 2000 CCSVI MS Duplex exams.

Anatomic differences and localizations between the two groups of patients at
Duplex exams.

MRI imaging of MS Patients and Meniere Disease Patients, with comparison
and/or differences (anatomical, morphological)

Conclusions that mainly highlight the characteristics of the venous
abnormalities within Meniere Disease.

Ziv Haskal MD ‏@ZHaskal
Dr Bavaro, Italy, suggests a correlation btw higher jugular v abnlties in Meniere Disease, in early case control study. ISNVD mtg, Naples.