Therapeutic Response of Meniere's Disease Utilizing Sorbus domestica

Abstract

Introduction Meniere's disease (MD) is a chronic condition characterized by episodic attacks of vertigo, fluctuating hearing loss, and tinnitus. MD can impart a significant socioeconomic impact with associated progressive hearing loss. First-line therapies consist of diuretics and antihistamines, with second-line therapies including intratympanic steroids and pulse therapy. Third-line treatments include endolymphatic sac surgery (ELSS) followed by intratympanic gentamicin injection and/or vestibular neurectomy. The gemmotherapy Sorbus domestica's inherent properties to regulate venous circulation and lymphatic drainage have been utilized in the European literature for the treatment of MD and the patients in this study. Methods Patients presenting for rehabilitation at Pulaski Health and Rehabilitation Facility with a history of vertigo were examined and, through history and specific exam, to define MD. This resulted in six patients whose symptoms and exam were consistent with MD and interfered with their therapeutic progression. These patients were offered and accepted treatment with Sorbus domestica for their MD. Results All patients responded with either resolution or significant improvement in their symptoms and hearing loss. Treatment also resulted in an improved and probably shortened rehabilitative course. All patients had no adverse reactions and were supplied with resources for continual treatment upon discharge. Conclusion Sorbus domestica is a safe and viable treatment option for MD. It has been useful, especially in treatment-resistant diseases, without side effects and can be utilized in initial cases with improvement or resolution of hearing loss.

Keywords: gemmotherapy; meniere’s disease; sorbus domestica; tinnitus; vertigo.

Figure 1. Examples of two labyrinths, one normal and the other with EH

EH, endolymphatic hydrops De Luca P, Cassandro C, Ralli M, Gioacchini FM, Turchetta R, Orlando MP, Iaccarino I, Cavaliere M, Cassandro E, Scarpa A. Dietary Restriction for The Treatment of Meniere's Disease. Transl Med UniSa. 2020 May 31;22:5-9 PMC7265917. open-access article distributed under the terms of the Creative Commons Attribution License

Figure 2. ICON algorithm for the treatment of MD

The figure represents a proposal of an algorithm for MD treatment as an ICON obtains for the IFOS meeting 2017. The first line of treatment includes medical conservative treatment. After this line of treatment, 80% of patients with MD are cured or in remission. Then the second line is the IT injections, mainly ITC as a conservative treatment and ITG in case of failure and preferentially in patients with hearing impairment. After this second line, 90% to 95% of the patients are cured or in remission. The third line is the surgical, conservative, or destructive treatment. If indicated, ELSS must be indicated before ITG. ITC, intratympanic injection of corticosteroids; DXM, dexamethasone; ITG, intratympanic injection of gentamycin; ELSS, endolymphatic sac surgery; VN, vestibular neurectomy; labyrinthectomy +/- Cl (with and without gentamycin); ICON, international consensus; MD, Ménière's disease Reproduced from Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V: International consensus (ICON) on treatment of Ménière’s disease. Eur Ann Otorhinolaryngol Head Neck Dis. 2018, 135:S29–32. 10.1016/j.anorl.2017.12.006 Permission by permissionfranceelsevior.com