Hypothesis: A review of the most recent literature will provide clinicians with an update of secondary endolymphatic hydrops, aiding in diagnosis and treatment of affected patients. Background: Secondary endolymphatic hydrops is a pathologic finding of the inner ear resulting in episodic vertigo and intermittent hearing loss. It is a finding for which extensive research is being performed. Methods: A review of the most recent literature on secondary endolymphatic hydrops was performed using PubMed literature search. Results: Recent investigation of secondary endolymphatic hydrops has brought attention to traumatic and inflammatory insults as causes for secondary endolymphatic hydrops. Such etiologies, including postsurgical effects of cochlear implantation and endolymphatic sac ablation; otosclerosis and its operative intervention(s); acoustic and mechanical trauma; medications; and systemic inflammatory processes, have been determined as causes of secondary lymphatic hydrops. Histopathological slides for many of the etiologies of secondary endolymphatic hydrops are presented. Conclusion: Through an understanding of the pathophysiology and etiologies of secondary endolymphatic hydrops, clinicians will gain a better understanding of this complex disease process, which will aid in treatment of patients with this disease process.

La Sindrome di Ménière, una condizione descritta nel 1800, è stata un’area di grande interesse clinico e di ricerca scientifica negli ultimi decenni. Le linee guida pubblicate dall’ American Academy of Otolaryngology-Head and Neck Surgery sono rimaste pressoché invariate per quasi 20 anni, benché la ricerca scientifica sugli aspetti eziopatologici sia indubbiamente molto progredita nel frattempo. La presente revisione della letteratura evidenzia gli importanti progressi compiuti nella comprensione della fisiopatologia di questa malattia enigmatica. Le evidenze discusse sono inoltre accompagnate da una documentazione iconografica istopatologica. L’obiettivo della presente trattazione è fornire al lettore un quadro aggiornato ed accurato sulle teorie inerenti la Sindrome di Ménière.

There are insufficient data regarding the safety of otologic procedures in the setting of the coronavirus disease 2019 (COVID‐19) pandemic. Given the proclivity for respiratory pathogens to involve the middle ear and the significant aerosolization associated with many otologic procedures, safety precautions should follow current recommendations for procedures involving the upper airway. Until preoperative diagnostic testing becomes standardized and readily available, elective cases should be deferred and emergent/urgent cases should be treated as high risk for COVID‐19 exposure. Necessary otologic procedures on positive, suspected, or unknown COVID‐19 status patients should be performed using enhanced personal protective equipment, including an N95 respirator and eye protection or powered air‐purifying respirator (PAPR, preferred), disposable cap, disposable gown, and gloves. Powered instrumentation should be avoided unless absolutely necessary, and if performed, PAPR or sealed eye protection is recommended.

Pott's Puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma predominantly in the adolescent age group. Pott's Puffy tumor can be associated with cortical vein thrombosis, epidural abscess, subdural empyema, and brain abscess. The cause of vein thrombosis is explained by venous derange of the frontal sinus, which occurs through diplopic veins, which communicate with the dural venous plexus; septic thrombi can potentially evolve from foci within the frontal sinus and propagate through this venous system. An apparently healthy 7-year-old girl presented to the emergency service of otolaryngology with complaints of swelling of forehead and periorbital zone, headache, chills, fever, and rhinorrhea. The patient described in this case report had 2 important complications of paranasal sinus disease: the relatively common complication of postseptal cellulites and the less common complication of Pott's Puffy tumor.

Objective: To evaluate current trends in managing Ménière's disease (MD) by both general otolaryngologists and otologists/neurotologists and discuss treatment modalities. Study Design: Cross-sectional study. Setting: Survey of physicians. Subjects and Methods: An electronic questionnaire was disseminated to all members of American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS). Results: Eight hundred and sixty members replied for a response rate of 14.5% for generalists and 35% for neurotologists. Thirty-nine percent of respondents think that diet and lifestyle changes are effective in controlling symptoms in more than 50% of their MD patients. Overall, 72.8% of respondents used hydrochlorothiazide/triamterene (HCTZ/TAT) “often” or “always” with neurotologists using HCTZ/TAT more often than generalists (p < 0.001). Half of neurotologists used IT steroids “often” or “always,” compared with only 10% of generalists (p < 0.001). Endolymphatic sac procedures are the most common surgeries and are used more often by neurotologists than by generalists (p < 0.001). The Medtronic Meniett device is used more by neurotologists (p < 0.001) but it is not commonly used overall (69.2% “never” use). Conclusion: Many options are available for the treatment of MD. Neurotologists tend to use a wider variety of medications in their treatment protocols than generalists. Neurotologists tend to perform surgical interventions more frequently than generalists. Our evidence shows significant heterogeneity for treatment of Ménière's disease among otolaryngologists. A guideline that outlines appropriate therapeutic options, dosing, and treatment escalation is warranted.