Long-Term Risk of Progression From Unilateral to Bilateral Méniere's Disease: A Systematic Review and Meta-Analysis.

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Otology & Neurotology Pub Date : 2025-06-01 Epub Date: 2025-04-11 DOI:10.1097/MAO.0000000000004491

Thomas James Hudson, Linette Shu Hwei Tan, Veronica Phillips, Jameel Muzaffar, Manohar Bance

{"title":"Long-Term Risk of Progression From Unilateral to Bilateral Méniere's Disease: A Systematic Review and Meta-Analysis.","authors":"Thomas James Hudson, Linette Shu Hwei Tan, Veronica Phillips, Jameel Muzaffar, Manohar Bance","doi":"10.1097/MAO.0000000000004491","DOIUrl":null,"url":null,"abstract":"Objective: To evaluate the overall risk of conversion from unilateral to bilateral Méniere's disease (MD), the time interval from initial diagnosis to conversion, and any risk factors or audiometric trends associated with this process.Databases reviewed: Medline, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.Gov.Methods: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting longitudinal progression of unilateral to bilateral MD were included. Random-effects meta-analyses were performed to evaluate the proportion of cases that converted and the mean time to conversion, and a narrative synthesis described risk factors and audiometric data.Results: A total of 11 studies met the inclusion criteria. For overall conversion risk, meta-analysis of the 9 relevant studies (n = 1583) yielded a risk of 13% (95% CI, 12-15%). Mean time to conversion was 8.2 years (95% CI, 5.9-10.6; I2 = 46%), and a combined Kaplan-Meier analysis revealed a prolonged distribution of conversions including 10% that converted 20 years or later after initial diagnosis. Risk factors and audiometric data were sparsely reported, but there may be a correlation between conversion risk and first-sided ear surgery (protective), history of tympanic membrane perforation, and baseline hearing loss in the unaffected ear.Conclusion: There is a significant risk of conversion from unilateral to bilateral MD that must be taken into account when considering ablative treatment options, even late into its course. Further work will be required to better characterize risk/protective factors and audiometric trends.","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 5","pages":"485-493"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otology & Neurotology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MAO.0000000000004491","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/11 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To evaluate the overall risk of conversion from unilateral to bilateral Méniere's disease (MD), the time interval from initial diagnosis to conversion, and any risk factors or audiometric trends associated with this process.

Databases reviewed: Medline, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.Gov.

Methods: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting longitudinal progression of unilateral to bilateral MD were included. Random-effects meta-analyses were performed to evaluate the proportion of cases that converted and the mean time to conversion, and a narrative synthesis described risk factors and audiometric data.

Results: A total of 11 studies met the inclusion criteria. For overall conversion risk, meta-analysis of the 9 relevant studies (n = 1583) yielded a risk of 13% (95% CI, 12-15%). Mean time to conversion was 8.2 years (95% CI, 5.9-10.6; I2 = 46%), and a combined Kaplan-Meier analysis revealed a prolonged distribution of conversions including 10% that converted 20 years or later after initial diagnosis. Risk factors and audiometric data were sparsely reported, but there may be a correlation between conversion risk and first-sided ear surgery (protective), history of tympanic membrane perforation, and baseline hearing loss in the unaffected ear.

Conclusion: There is a significant risk of conversion from unilateral to bilateral MD that must be taken into account when considering ablative treatment options, even late into its course. Further work will be required to better characterize risk/protective factors and audiometric trends.

查看原文本刊更多论文

从单侧到双侧msamniere病进展的长期风险：系统回顾和荟萃分析。

目的：评价单侧向双侧msamniere病（MD）转化的总体风险，从最初诊断到转化的时间间隔，以及与此过程相关的任何危险因素或听力学趋势。纳入的数据库：Medline、Embase、Cochrane Library、Scopus、Web of Science和clinicaltrials。方法：本综述根据系统评价和meta分析（PRISMA）指南的首选报告项目进行报道。报告单侧至双侧MD纵向进展的研究被纳入。进行随机效应荟萃分析以评估转换病例的比例和平均转换时间，并进行叙述性综合描述风险因素和听力测量数据。结果：共有11项研究符合纳入标准。对于总转换风险，9项相关研究（n = 1583）的荟萃分析得出风险为13% （95% CI, 12-15%）。平均转化时间为8.2年(95% CI, 5.9-10.6；I2 = 46%)，联合Kaplan-Meier分析揭示了转诊的长期分布，其中10%在初次诊断后20年或更晚才转诊。危险因素和听力学数据很少报道，但转换风险可能与单侧耳部手术（保护性）、鼓膜穿孔史和未受影响耳的基线听力损失有关。结论：单侧MD向双侧MD转变的风险很大，在考虑消融治疗方案时必须考虑到这一点，即使在病程后期也是如此。将需要进一步的工作来更好地描述风险/保护因素和听力测量趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Otology & Neurotology 医学-耳鼻喉科学

CiteScore

3.80

自引率

14.30%

发文量

509

审稿时长

3-6 weeks

期刊介绍： Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.