Clinical management and outcome of Meniere’s disease in children and adolescents: A systematic review

Introduction

Meniere's disease (MD), or idiopathic endolymphatic hydrops, has been well-established in adults. However, due to the lack of understanding of pathomechanism and the progression of MD in children, managing this condition remains a challenge. The review aims to investigate the clinical management and outcome of treatments in children and adolescents with MD.

Methods

A systematic literature review was conducted in accordance with PRISMA guidelines to identify articles that assessed the outcome of treatment among children with MD. Information regarding the child's demographic data, MD symptoms, investigations, treatment, and outcomes was extracted from the included studies. The primary outcome was defined as the success of treatment based on the resolution or improvements of symptoms, while the secondary outcome was determined by recurrence or worsening symptoms or the presence of complications.

Results

The review included 12 studies published between 1958 and 2024. Fifty-seven children were noted, with a mean age of 9.9 ± 3.1 (range 5–14 years) and female predominance (60 %). Most of the included articles were from Asian countries (66.6 %), followed by Europe (16.7 %) and the USA (16.7 %). Improvement of symptoms was reported in 91.7 % of the included studies, with recurrence reported in four studies and persistence in symptoms found in one study. Diuretics were the most favoured intervention. Endolymphatic sac decompression is the favoured surgical option. Complications reported include worsening hearing found in two children (3.5 %).

Conclusion

Pharmacological and surgical treatment results in good outcomes in children with MD. However, the quality of the evidence is inadequate to recommend the ideal intervention until a better-quality study has been completed. Future randomised controlled studies with a large sample size are warranted to determine the ideal intervention in children with MD.