European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 4, pp 1231–1235 | Cite as

Effect of standard-dose Betahistine on endolymphatic hydrops: an MRI pilot study

  • R. Gürkov
  • W. Flatz
  • D. Keeser
  • M. Strupp
  • B. Ertl-Wagner
  • E. Krause


This study aimed to assess whether standard-dose Betahistine (48 mg daily) exerts an effect upon the degree of endolymphatic hydrops in patients with Menière’s disease using a retrospective case series in the setting of a tertiary neurotology referral centre. In six patients with definite unilateral Menière’s disease, the degree of cochlear and vestibular endolymphatic hydrops was assessed before and after treatment with a standard dose of Betahistine (48 mg daily), using high-resolution 3 T MR imaging after intratympanic contrast medium application. The treatment duration was 3–7 months (mean 5 months), and the patients were followed-up for 6–29 months (mean 11 months). In the study cohort, the standard dose of Betahistine did not have an MR morphologically measurable beneficial effect on the degree of endolymphatic hydrops. The results indicated no effect of standard-dose Betahistine on endolymphatic hydrops found on high-resolution MR imaging. Possible explanations are: (1) insufficient dosage or duration of treatment with betahistine, (2) insufficient resolution of the MR imaging technique, and (3) insufficient length of follow-up. Further studies addressing these issues are warranted.


Menière’s disease Endolymphatic hydrops Betahistine Magnetic resonance imaging 



This study was supported by the Federal German Ministry of Education and Research (Grant no. 01EO0901). The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of interest

None of the authors have a conflict of interest to declare.


  1. 1.
    Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. (1995) Otolaryngol Head Neck Surg 113:181-185Google Scholar
  2. 2.
    Merchant SN, Adams JC, Nadol JB Jr (2005) Pathophysiology of Meniere’s syndrome: are symptoms caused by endolymphatic hydrops? Otol Neurotol 26:74–81PubMedCrossRefGoogle Scholar
  3. 3.
    Kim HH, Wiet RJ, Battista RA (2005) Trends in the diagnosis and the management of Meniere’s disease: results of a survey. Otolaryngol Head Neck Surg 132:722–726PubMedCrossRefGoogle Scholar
  4. 4.
    Westhofen M (2009) Meniere’s disease: evidence and controversies. HNO 57:446–454PubMedCrossRefGoogle Scholar
  5. 5.
    Smith WK, Sankar V, Pfleiderer AG (2005) A national survey amongst UK otolaryngologists regarding the treatment of Meniere’s disease. J Laryngol Otol 119:102–105PubMedGoogle Scholar
  6. 6.
    Timmerman H (1991) Histamine agonists and antagonists. Acta Otolaryngol Suppl 479:5–11PubMedCrossRefGoogle Scholar
  7. 7.
    Arrang JM, Devaux B, Chodkiewicz JP et al (1988) H3-receptors control histamine release in human brain. J Neurochem 51:105–108PubMedCrossRefGoogle Scholar
  8. 8.
    Martinez DM (1972) The effect of Serc (betahistine hydrochloride) on the circulation of the inner ear in experimental animals. Acta Otolaryngol Suppl 305:29–47PubMedCrossRefGoogle Scholar
  9. 9.
    James AL, Burton MJ (2001) Betahistine for Meniere’s disease or syndrome. Cochrane Database Syst Rev (1):CD001873Google Scholar
  10. 10.
    Nakashima T, Naganawa S, Sugiura M et al (2007) Visualization of endolymphatic hydrops in patients with Meniere’s Disease. The Laryngoscope 117:415–420PubMedCrossRefGoogle Scholar
  11. 11.
    Gurkov R, Flatz W, Louza J et al (2011) In vivo visualization of endolyphatic hydrops in patients with Meniere’s disease: correlation with audiovestibular function. Eur Arch Otorhinolaryngol 268:1743–1748PubMedCrossRefGoogle Scholar
  12. 12.
    Louza J, Flatz W, Krause E, Gürkov R (2012) Short-term audiologic effect of intratympanic gadolinium contrast agent application in patients with Meniere’s disease. Am J Otolaryngol [Epub ahead of print]Google Scholar
  13. 13.
    Suzuki H, Teranishi M, Naganawa S et al (2011) Contrast-enhanced MRI of the inner ear after intratympanic injection of meglumine gadopentetate or gadodiamide hydrate. Acta Otolaryngol 131:130–135PubMedCrossRefGoogle Scholar
  14. 14.
    Kato M, Teranishi M, Katayama N et al (2011) Association between endolymphatic hydrops as revealed by magnetic resonance imaging and caloric response. Otol Neurotol 32:1480–1485PubMedCrossRefGoogle Scholar
  15. 15.
    Hornibrook J, Coates M, Goh A et al (2012) Magnetic resonance imaging for Meniere’s disease: correlation with tone burst electrocochleography. J Laryngol Otol 126:136–141PubMedCrossRefGoogle Scholar
  16. 16.
    Horii A, Osaki Y, Kitahara T et al (2011) Endolymphatic hydrops in Meniere’s disease detected by MRI after intratympanic administration of gadolinium: comparison with sudden deafness. Acta Otolaryngol 131:602–609PubMedCrossRefGoogle Scholar
  17. 17.
    Fang ZM, Chen X, Gu X, Liu Y, Zhang R, Cao DR, He HG (2012) A new magnetic resonance imaging scoring system for perilymphatic space appearance after intratympanic gadolinium injection, and its clinical application. J Laryngol Otol 126(5):454–459Google Scholar
  18. 18.
    Laurikainen E, Miller JM, Nuttall AL et al (1998) The vascular mechanism of action of betahistine in the inner ear of the guinea pig. Eur Arch Otorhinolaryngol 255:119–123PubMedCrossRefGoogle Scholar
  19. 19.
    Laurikainen E, Miller JF, Pyykko I (2000) Betahistine effects on cochlear blood flow: from the laboratory to the clinic. Acta Otolaryngol Suppl 544:5–7PubMedCrossRefGoogle Scholar
  20. 20.
    Strupp M, Hupert D, Frenzel C (2008) Long-term prophylactic treatment of attacks of vertigo in Meniere’s disease–comparison of a high with a low dosage of betahistine in an open trial. Acta Otolaryngol 128:520–524PubMedCrossRefGoogle Scholar
  21. 21.
    Lezius F, Adrion C, Mansmann U et al (2011) High-dosage betahistine dihydrochloride between 288 and 480 mg/day in patients with severe Meniere’s disease: a case series. Eur Arch Otorhinolaryngol 268:1237–1240PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • R. Gürkov
    • 1
  • W. Flatz
    • 2
  • D. Keeser
    • 1
    • 2
  • M. Strupp
    • 3
  • B. Ertl-Wagner
    • 2
  • E. Krause
    • 1
  1. 1.Department of Otorhinolaryngology Head and Neck Surgery, Integrated Centre for Balance Disorders, Grosshadern Medical CentreUniversity of MunichMunichGermany
  2. 2.Department of Radiology, Grosshadern Medical CentreUniversity of MunichMunichGermany
  3. 3.Department of Neurology, Integrated Centre for Balance Disorders, Grosshadern Medical CentreUniversity of MunichMunichGermany

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