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Casani AP, Albera R, Piras C, Albera A, Noto A, Ducci N, Atzori L, Lucisano S, Mussap M, Fanos V. Clinical Efficacy and Metabolomics Modifications Induced by Polyphenol Compound Supplementation in the Treatment of Residual Dizziness following Semont Maneuver in Benign Paroxysmal Positional Vertigo (BPPV) of the Posterior Semicircular Canal (PSC): Preliminary Results. Metabolites 2024; 14:86. [PMID: 38392978 PMCID: PMC10890690 DOI: 10.3390/metabo14020086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/14/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) represents the most frequent cause of peripheral vertigo. In most cases, it is successfully treated using the canalith repositioning procedure, but it is often followed by continuous lightheadedness in the absence of vertigo or nystagmus (residual dizziness, RD). Our aim is to describe the clinical effectiveness and the urine metabolomics profile of treating these patients with polyphenol compound supplementation. We enrolled 30 patients reporting RD after BPPV of the posterior semicircular canal (PSC) successfully treated using the Semont maneuver. Supplementation with a polyphenol compound was administered for 60 days, and patients were evaluated after 30 and 60 days of treatment using self-administered questionnaires (Visual Analog Scales for Dizziness and Nausea, Dizziness Handicap Inventory, DHI) and urine metabolomics analysis performed using 1H-NMR spectroscopy and multivariate followed by univariate analysis. Most patients reported excellent or good efficacy in the treatment of RD with a significant decrease in VAS and DHI values. The metabolomics analysis identified six significant metabolites related to the treatment, namely 1-methylnicotinamide, anserine, hippurate, lysine, methyl succinate and urea, indicating the inflammatory activities and antioxidant properties of the polyphenol compound. These preliminary data suggest that supplementation with a polyphenol compound could induce some metabolic changes that can help in recovery from RD. However, future steps will require confirmation with a more significant cohort of patients and an extension of the metabolomics evaluation to other problems concerning the different clinical aspects of BPPV, such as the high rate of relapse.
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Affiliation(s)
- Augusto Pietro Casani
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University Hospital, 56024 Pisa, Italy
| | - Roberto Albera
- Department of Surgical Sciences, University of Turin, 10024 Turin, Italy
| | - Cristina Piras
- Department of Biomedical Sciences, University of Cagliari, 09121 Cagliari, Italy
| | - Andrea Albera
- Department of Surgical Sciences, University of Turin, 10024 Turin, Italy
| | - Antonio Noto
- Department of Biomedical Sciences, University of Cagliari, 09121 Cagliari, Italy
| | - Nicola Ducci
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University Hospital, 56024 Pisa, Italy
| | - Luigi Atzori
- Department of Biomedical Sciences, University of Cagliari, 09121 Cagliari, Italy
| | - Sergio Lucisano
- Department of Surgical Sciences, University of Turin, 10024 Turin, Italy
| | - Michele Mussap
- Department of Surgical Sciences, University of Cagliari, 09121 Cagliari, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, 09121 Cagliari, Italy
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Noto A, Piras C, Atzori L, Mussap M, Albera A, Albera R, Casani AP, Capobianco S, Fanos V. Metabolomics in Otorhinolaryngology. Front Mol Biosci 2022; 9:934311. [PMID: 36158568 PMCID: PMC9493185 DOI: 10.3389/fmolb.2022.934311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Otorhinolaryngology (Ear, Nose and Throat-ENT) focuses on inflammatory, immunological, infectious, and neoplastic disorders of the head and neck and on their medical and surgical therapy. The fields of interest of this discipline are the ear, the nose and its paranasal sinuses, the oral cavity, the pharynx, the larynx, and the neck. Besides surgery, there are many other diagnostic aspects of ENT such as audiology and Vestibology, laryngology, phoniatrics, and rhinology. A new advanced technology, named metabolomics, is significantly impacting the field of ENT. All the “omics” sciences, such as genomics, transcriptomics, and proteomics, converge at the level of metabolomics, which is considered the integration of all “omics.” Its application will change the way several of ENT disorders are diagnosed and treated. This review highlights the power of metabolomics, including its pitfalls and promise, and several of its most relevant applications in ENT to provide a basic understanding of the metabolites associated with these districts. In particular, the attention has been focused on different heterogeneous diseases, from head and neck cancer to allergic rhinitis, hearing loss, obstructive sleep apnea, noise trauma, sinusitis, and Meniere’s disease. In conclusion, metabolomics study indicates a “fil rouge” that links these pathologies to improve three aspects of patient care: diagnostics, prognostics, and therapeutics, which in one word is defined as precision medicine.
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Affiliation(s)
- Antonio Noto
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Cristina Piras
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Luigi Atzori
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Michele Mussap
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Andrea Albera
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Roberto Albera
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Augusto Pietro Casani
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University Hospital, Pisa, Italy
- *Correspondence: Augusto Pietro Casani,
| | - Silvia Capobianco
- Department of Medical and Surgical Pathology, Otorhinolaryngology Section, Pisa University Hospital, Pisa, Italy
| | - Vassilios Fanos
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
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Ishii M, Ishiyama G, Ishiyama A, Kato Y, Mochizuki F, Ito Y. Relationship Between the Onset of Ménière's Disease and Sympathetic Hyperactivity. Front Neurol 2022; 13:804777. [PMID: 35370896 PMCID: PMC8970286 DOI: 10.3389/fneur.2022.804777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The pathogenesis of Ménière's disease is still largely unknown; however, it is known to be strongly associated with stress. Excessive stress can cause hyperactivity of the sympathetic autonomic nervous system. With the aim of understanding changes in sympathetic hyperactivity before and after Ménière's disease, we compared autonomic nervous function in patients in a stable phase of Ménière's disease and that in healthy adults. We also gathered data over about 10 years on autonomic nervous function immediately before a Ménière's attack. Study Design Prospective study. Patients Autonomic nervous function was analyzed in 129 patients in a stable phase of Ménière's disease 31 healthy adult volunteers. In nine patients, autonomic nervous function was also measured immediately before and after treatment of a vertigo attack. Main Outcome Measure Power spectrum analysis of heart rate variability (HRV) of EEG/ECG and an infrared electronic pupillometer were used. Sympathetic and parasympathetic nervous function was measured. Results There were no statistically significant differences in autonomic nervous function determined by HRV and electronic pupillometry between patients in a stable phase of Ménière's disease and healthy adults. Sympathetic function as measured by electronic pupillometry parameters VD and T5 showed no difference between the affected and unaffected sides in the baseline data measured in the stable phase (VD: affected side is 31.02 ± 6.16 mm/sec, unaffected side is 29.25 ± 5.73 mm/sec; T5: affected side is 3.37 ± 0.43 msec, unaffected side is 3.25 ± 0.39 msec). In contrast, all nine patients whose HRV data had been obtained just before an attack showed marked suppression of the parasympathetic nervous system and activation of the sympathetic nervous system. Electronic pupillometry also revealed an overactivation of the sympathetic nervous system on the affected side, just before the attacks. Analysis of sequential changes after the onset of an attack revealed that overactivation on the affected side was reduced after treatment, and no difference between affected and unaffected sides was observed 3 days after treatment. Conclusion Detailed analysis of autonomic nervous function showed that immediately before an attack of Ménière's disease, the sympathetic nervous system on the affected side was strongly overactivated.
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Affiliation(s)
- Masanori Ishii
- Department of Otorhinolaryngology, Japan Community Health Care Organization (JCHO) Tokyo Shinjuku Medical Center, Tokyo, Japan
- Department of Otorhinolaryngology and Head & Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
- *Correspondence: Masanori Ishii
| | - Gail Ishiyama
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Akira Ishiyama
- Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Yujin Kato
- Department of Otorhinolaryngology and Head & Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Fumihiro Mochizuki
- Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yusuke Ito
- Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kanagawa, Japan
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Berardino FD, Conte G, Turati F, Ferraroni M, Zanetti D. Cochlear implantation in Ménière's disease: a systematic review of literature and pooled analysis. Int J Audiol 2020; 59:406-415. [PMID: 32027195 DOI: 10.1080/14992027.2020.1720922] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of this study was to evaluate the effect of cochlear implantation (CI) in advanced Ménière's disease (MD).Design: The initial search on PubMed, EMBASE, and Cochrane databases yielded 171 articles; no language restriction was applied.Study sample: A total of 11 articles met the inclusion criteria and were included in this systematic review. Six articles provided patient-level data on improvement in speech recognition testing after CI.Results: The methodological quality of included studies was assessed by examining the study design, level of evidence, method of measurement and adequacy of outcome reporting. A random-effect model was fitted for calculating weighted means. Post-operative improvement in word recognition score (WCS) was 50.8% (95% confidence interval: 34.6-67.1%); general improvement of vestibular symptoms after CI was found in 67% of the pooled patients; when reported in the studies, quality of life (QoL) and tinnitus were also generally improved after CI.Conclusions: CI in advanced MD is a valid option providing good outcomes in terms of speech performances, regardless of the disease duration, uni- or bilaterality, age at implantation, previous therapeutic procedures and stage of activity of MD.
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Affiliation(s)
- Federica Di Berardino
- Audiology Unit, Dept of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Specialist Surgical Sciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
| | - Giorgio Conte
- Department of Neuroradiology, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
| | - Federica Turati
- Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Monica Ferraroni
- Laboratory of Medical Statistics, Biometry and Epidemiology "G.A. Maccacaro", Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Dept of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Specialist Surgical Sciences, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, University of Milano, Milan, Italy
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Increased urinary volumes in symptomatic Ménière's Disease. BMC Res Notes 2019; 12:826. [PMID: 31878980 PMCID: PMC6933934 DOI: 10.1186/s13104-019-4870-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/19/2019] [Indexed: 11/10/2022] Open
Abstract
Objective The purpose of the research is to test the measurement of the total urinary volume, induced by the diuretic osmotic action of mannitol, in a group of symptomatic MD patients and in healthy controls. Results An altered excretory urinary volume after mannitol challenge was observed in symptomatic MD (874.3 ± 302.1) compared to healthy volunteers (361.7 ± 181.6) (p = 0.0001). This easy and self-administered method might be proposed to replace the analysis of the urinary sugars’ concentration in symptomatic MD patients.
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