Chronic cerebrospinal venous insufficiency in Ménière’s disease: diagnosis and treatment

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Aldo Bruno *
Luigi Califano
Diego Mastrangelo
Marcella De Vizia
Benedetto Bernardo
Francesca Salafia
(*) Corresponding Author:
Aldo Bruno | aldobruno@webmail.it

Abstract

The purpose of this study was to evaluate by the means of Doppler ultrasound and phlebography the relationship between Ménière’s disease (MD) and chronic cerebrospinal venous insufficiency (CCSVI) and to test whether angioplasty is effective in improving symptoms. Phase 1: 50 patients diagnosed with definite MD (American Academy of Otolaryngology 1995) who had gained no benefit from routine therapy, underwent echoenhanced color Doppler sonography using the Zamboni protocol to check for CCSVI. Onehundred healthy subjects matched for age and gender acted as controls. Phase 2: in 20 of echo-color Doppler positive Ménière’s cases we performed a venogram and the diagnosis of associated CCSVI was confirmed. These patients were simultaneously treated by angioplasty of the internal jugular vein, then re-tested respect the baseline scales of MD. Out of a total of 50 patients with MD, an ultrasound diagnosis was made of CCSVI in 45 patients (90%). In the healthy population CCSVI is found in only 3% of cases (P<0.001). Twenty patients were given venograms that confirmed the CCSVI diagnosis. Finally, percutaneous transluminal angioplasty (PTA) proved to be effective in 90% of patients, with significant improvement of several scales of vestibular function at six months follow-up. There is a significant prevalence of CCSVI in patients with MD and treatment with PTA seems useful because of an improvement in symptoms and vestibular function recorded in the majority of patients.


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Article Details

Author Biographies

Aldo Bruno, Vascular Surgery Department, Clinica Gepos, Telese Terme (BN)

Surgeon

Luigi Califano, SSD Audiology and Phoniatrics, G. Rummo Hospital, Benevento

Chef Department

Diego Mastrangelo, Vascular Surgery Department, Clinica Gepos, Telese Terme (BN)

Surgeon

Benedetto Bernardo, Vascular Surgery Department, Clinica Gepos, Telese Terme (BN)

Chef of Service

Francesca Salafia, SSD Audiology and Phoniatrics, G. Rummo Hospital, Benevento

Surgeon