Therapeutic illusion: another frontier in Ménière's disease

Idiopathic endolymphatic hydrops, often referred as Ménière’s disease (MD) is characterized by episodes of vertigo, hearing loss, tinnitus, and aural fullness (1,2). It is often a challenge in diagnosis and description, mostly because of its variability, which can make it difficult to recognize, thus possibly delaying treatment (3).

Hearing loss has been widely studied, a fact that inclusively supports its staging according to the different guidelines proposed (4). Vertigo attacks appear to be the factor that affects more the health related quality of life of these patients as such, the primary goal of treatment is to reduce the frequency, intensity and duration of these episodes (1,5).

There are several difficulties, any author must stand, when analyzing results obtained with any MD treatment proposed. Fluctuation nature of the disease, the high and unexpected spontaneous remission rate, the difficulty of including a control group of patients without any intervention and the lack of validated instruments related to vertigo outcomes (other than disability and quality of life measurements) are clear examples of such problems. Here lies the importance of an appropriate clinical trial design, in order to prevent those possible methodological errors. 

CITA DEL ARTÍCULO  Ann Transl Med. 2016 Oct;4(Suppl 1):S63.