Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review

Meniere’s disease (MD) is a condition characterised by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo. The disabling vertigo symptoms can be controlled in most patients by lifestyle changes and medications such as diuretics. Should standard me...

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Main Authors: Wong Kein Low, Esther Jiayi Lim
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Otolaryngology
Online Access:http://dx.doi.org/10.1155/2021/5592611
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author Wong Kein Low
Esther Jiayi Lim
author_facet Wong Kein Low
Esther Jiayi Lim
author_sort Wong Kein Low
collection DOAJ
description Meniere’s disease (MD) is a condition characterised by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo. The disabling vertigo symptoms can be controlled in most patients by lifestyle changes and medications such as diuretics. Should standard medical therapy fail, the patient may require surgery in order to control the disease, but such surgical procedures can be functionally destructive. Obstructive sleep apnoea syndrome (OSAS) is common, especially in people who are grossly overweight. Up to 15% of patients with MD may have concomitant OSA. Unless the OSA is well controlled, such patients may continue to experience MD symptoms despite receiving adequate standard medical therapy for MD. Moreover, MD patients may experience insomnia as a result of vertigo and/or tinnitus where sedatives are indicated. The use of sedatives with muscle relaxant properties may inadvertently further aggravate OSA resulting in a vicious cycle of symptoms. Symptoms suggestive of concomitant OSA must be proactively sought as these patients do not necessarily exhibit the obvious phenotypic features of OSA. This is especially so in Asians where OSAS is commonly observed in people who are not overly obese. We report a case of a female patient who presented with recalcitrant MD disease and was later found to have concomitant OSA. The relevant literature will be reviewed, and learning points will be discussed from the perspective of the otologist/neurotologist. The clinician must always be mindful of the existence of concomitant “silent” OSAS as this impacts the management of patients with MD.
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spelling doaj-art-4980f27569d34abb8ec459d56ec2cb792025-08-20T02:39:21ZengWileyCase Reports in Otolaryngology2090-67652090-67732021-01-01202110.1155/2021/55926115592611Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature ReviewWong Kein Low0Esther Jiayi Lim1Novena Ent-Head & Neck Surgery Specialist Centre, 04-21/22/34, Mount Elizabeth Novena Medical Centre, 38 Irrawaddy Road, SingaporeNovena Ent-Head & Neck Surgery Specialist Centre, 04-21/22/34, Mount Elizabeth Novena Medical Centre, 38 Irrawaddy Road, SingaporeMeniere’s disease (MD) is a condition characterised by fluctuating and progressive hearing loss, aural fullness, tinnitus, and intermittent attacks of vertigo. The disabling vertigo symptoms can be controlled in most patients by lifestyle changes and medications such as diuretics. Should standard medical therapy fail, the patient may require surgery in order to control the disease, but such surgical procedures can be functionally destructive. Obstructive sleep apnoea syndrome (OSAS) is common, especially in people who are grossly overweight. Up to 15% of patients with MD may have concomitant OSA. Unless the OSA is well controlled, such patients may continue to experience MD symptoms despite receiving adequate standard medical therapy for MD. Moreover, MD patients may experience insomnia as a result of vertigo and/or tinnitus where sedatives are indicated. The use of sedatives with muscle relaxant properties may inadvertently further aggravate OSA resulting in a vicious cycle of symptoms. Symptoms suggestive of concomitant OSA must be proactively sought as these patients do not necessarily exhibit the obvious phenotypic features of OSA. This is especially so in Asians where OSAS is commonly observed in people who are not overly obese. We report a case of a female patient who presented with recalcitrant MD disease and was later found to have concomitant OSA. The relevant literature will be reviewed, and learning points will be discussed from the perspective of the otologist/neurotologist. The clinician must always be mindful of the existence of concomitant “silent” OSAS as this impacts the management of patients with MD.http://dx.doi.org/10.1155/2021/5592611
spellingShingle Wong Kein Low
Esther Jiayi Lim
Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
Case Reports in Otolaryngology
title Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
title_full Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
title_fullStr Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
title_full_unstemmed Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
title_short Concomitant Obstructive Sleep Apnoea in Patients with Meniere’s Disease: A Case Report and Literature Review
title_sort concomitant obstructive sleep apnoea in patients with meniere s disease a case report and literature review
url http://dx.doi.org/10.1155/2021/5592611
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