6
Diagnosis
Table 3. Summary of Key Action Statements (KAS)
Statement Action Grade
10. Positive Pressure
erapy
Clinicians should not prescribe positive
pressure therapy for patients with
Ménière's disease.
Recommendation
Against
11. Intratympanic
Steroid erapy
Clinicians may offer, or refer to a
clinician who can offer, intratympanic
steroids to patients with active Ménière's
disease not responsive to non-invasive
treatment.
Option
12. Intratympanic
Gentamicin
erapy
Clinicians should offer, or refer to a
clinician who can offer, intratympanic
gentamicin to patients with active
Ménière's disease not responsive to non-
ablative therapy.
Recommendation
13. Surgical Ablative
erapy
Clinicians may offer, or refer
to a clinician who may offer,
labyrinthectomy in patients with active
Ménière's disease who have failed less
definitive therapy and have non-usable
hearing.
Recommendation
14a. Role of
Vestibular
erapy for
Chronic
Imbalance
Clinicians should offer vestibular
rehabilitation/physical therapy for
Ménière's disease patients with chronic
imbalance.
Recommendation
14b. Role of
Vestibular
erapy for
Acute Vertigo
Clinicians should not recommend
vestibular rehabilitation/physical
therapy for managing acute vertigo
attacks in patients with Ménière's
disease.
Recommendation
Against
15. Counseling for
Amplification and
Hearing Assistive
Technolog y
Clinicians should counsel patients, or
refer to a clinician who can counsel
patients, with Ménière's disease and
hearing loss on the use of amplification
and hearing assistive technolog y.
Recommendation
16. Patient Outcomes Clinicians should document resolution,
improvement, or worsening of vertigo,
tinnitus, and hearing loss and any
change in quality of life in patients with
Ménière's disease aer treatment.
Recommendation
(cont'd)
