Guidelines of the French Society of ENT (short version) on the role and modalities of vestibular rehabilitation in Menière's disease.

INTRODUCTION

Menière's disease is a fluctuating pressure pathology featuring successive hydropic episodes of varying frequency and intensity. The accumulation of these episodes and of the certain treatments can induce vestibular deficit and episodes of chronic instability. Vestibular rehabilitation aims to limit everyday impact by developing compensation and adaptation. How and when should it be introduced?

MATERIAL AND

METHODS

A systematic review of the literature for the period 1963-2022 was conducted by an expert group comprising of ENT physicians and vestibular physiotherapists. For each reference, the level of evidence was recorded as 1, 2, 3, 4 or expert opinion. Recommendations were graded A, B or C according to the methodological quality of the underlying studies; when there was no evidence-based consensus, an "expert opinion" was formulated based on the group members' clinical practices.

RESULTS

Eighteen articles were selected via 4 scientific search engines (PubMed, Google Scholar, PEDro, Science Direct) and 3 keywords "Rehabilitation", "Vestibular rehabilitation", and "Menière's disease".

CONCLUSION

Vestibular rehabilitation is recommended in Menière's disease in case of uncompensated spontaneous progressive vestibular deficit or surgical or medical vestibular suppression (gentamicin injection). Rehabilitation should await a period of 3 months' stability, and be adapted to the individual complaint. It should be supervised by a rehabilitation professional: self-rehabilitation is not recommended.