Three patterns of chronic cerebrospinal venous insufficiency in Ménière syndrome patients: Diagnosis and treatment options

Identification techniques of the three different chronic cerebrospinal venous insufficiency patterns and related treatment options are in an initial phase of evaluation and analysis. Our purpose is to describe the appropriate management, proposing a tailored approach for each one. We identified three different Ménière syndrome patients in our Audiology Department, diagnosing the corresponding chronic cerebrospinal venous insufficiency pattern by Echo-color Doppler ultrasound evaluation and treating by venous angioplasty or rehabilitative treatment according to the internal jugular and vertebral veins anomalies found in each patient. According to the pattern, after specific treatment, echo-color-Doppler control analysis revealed a normalized venous outflow correlated to Ménière symptoms reduction and/or progressive disappearance during one year follow up. An adequate analysis of venous cerebral and ear outflow and a tailored treatment may represent an effective option when chronic cerebrospinal venous insufficiency is correctly diagnosed.