Treatment Options for Ménière's Disease
Some people with Ménière’s disease will benefit from lifestyle changes and medication. Others may need surgery. For those in between, there is another choice. Medtronic’s unique Meniett® therapy may reduce swelling and pressure in the inner ear. For some, that means relief from the disease’s worst symptom: vertigo.
For some patients, Ménière’s disease improves with or without treatment.1 For others, symptoms get worse. Doctors believe that Ménière’s disease is caused by excess swelling and fluid in the hearing and balance canals of the inner ear. Most treatments try to decrease this fluid.1-5 Your doctor will generally prescribe treatments in order of lower risk to higher risk6 to find one that controls your symptoms.
Diet/Lifestyle Changes and Medical Therapy
This treatment may include a low sodium diet, diuretic therapy, fluid intake, stress management, and various drugs.1,2
This micropressure therapy may reduce swelling and pressure in the inner ear to relieve symptoms of severe dizziness and vertigo.7-14 The American Academy of Otolaryngology recommends this type of therapy in certain cases of Ménière’s disease, especially after medical therapy fails.15
Surgical or Destructive Treatments
Usually, surgical treatment is only considered after all other treatments have failed to ease your symptoms. You and your doctor may decide to try a surgical or “destructive” treatment such as:
- Draining fluid from the inner ear16
- Cutting the balance nerve to reduce vertigo intensity17
- Removing the balance portion of the inner ear. This relieves the vertigo but causes complete, permanent hearing loss in the affected ear
- Chemical labyrinthectomy with drugs injected into the inner ear to reduce balance function and risk of hearing loss18, 19
If you have questions about your condition or are unclear about some of the treatment options, write them down and ask your ENT or ear specialist about them at your next doctor visit.
- Torok N. 1977. Old and new in Ménière’s disease. The Laryngoscope. 87(11):1870-1877.
- Schuknecht HF. 1975. Pathophysiology of Ménière’s disease. Otolaryngol Clin North Am. 8(2):507-514.
- Gulya AJ. Schuknecht HF. 1982. Classification of endolymphatic hydrops. Am J Otolaryngol. 3(5):319-322.
- Claes J, Van de Heyning PH. 1977. Medical treatment of Ménière’s disease: A review of literature. Acta Otolaryngol (Stockh). Suppl 526:10-13.
- Furstenberg AC, Lashmet FH, Lathrop FD. 1934. Ménière’s symptom complex: medical treatment. Ann Otol Rhinol Laryngol. 43:1035-1047.
- Peterson WM, Isaacson JE. Current management of Ménière’s disease in an only hearing ear. Otol Neurotol. 2007. Apr. 26. Epub ahead of print.
- Thomsen J, Sass K, Ödkvist L, Arlinger S. 2005. Local over-pressure treatment reduces vestibular symptoms in patients with Ménière’s disease: a clinical, randomized, multicenter, double-blind, placebo-controlled study. Otol Neurotol. 26:68-73.
- Gates GA, Green Jr. JD, Tucci DL, Telian SA. 2004. The effects of transtympanic micropressure treatment in people with unilateral Ménière’s disease. Arch of Oto – HNS. June:130(6):718-725.
- Densert B, Sass K. 2001. Control of symptoms in patients with Ménière’s disease using middle ear applications: A two-year follow-up. Acta Otolaryngol (Stockh). 120:5.
- Gates GA, Green Jr. JD. 2002. Intermittent pressure therapy of intractable Ménière’s disease using the Meniett device: a preliminary report. The Laryngoscope. 112:1489-1493.
- Ödkvist LM, Arlinger S, Billermark E, Densert B, Lindholm S, Wallquist J. 2000. Effects of middle ear pressure changes on clinical symptoms in patients with Ménière’s disease: A clinical, multicenter, placebo-controlled study. Acta Otolaryngol (Stockh). Suppl 543: 99-101.
- Densert B, Densert O, Arlinger S, Sass K, Ödkvist LM. 1997. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Ménière’s disease: A clinical placebo-controlled study. American Journal of Otology. 18:726-33.
- Gates GA, Verrall A, Green Jr. JD, Tucci DL, Telian SA. Meniett clinical trial: long-term follow-up. Arch Otolaryngol Head Neck Surg. 2006;132:1311-1316.
- Rajan GP, Din S, Atlas MD. 2005. Long-term effects of the Meniett device in Ménière’s disease: the Western Australian experience. J Laryngol Otol. 119:391-395.
- American Academy of Otolaryngology – Head and Neck Surgery (AAO-HNS) Committee on Equilibrium policy statement. AAO-HNS position on micropressure therapy. Released March 2008.
- Thomsen J, Bretlau P, Tos M, Johnsen NJ. 1981. Placebo effect in surgery for Ménière’s disease. A double-blind, placebo-controlled study on endolymphatic sac shunt surgery. Arch Otolaryngol. 107:271-277.
- Silverstein H, Arrada J. Kugler Publications. pp 369-79.
- Hellstrom S, Ödkvist LM. 1994. Pharmacologic labyrinthectomy. Otolaryngol Clin North Am. 27:307-315.
- LaRouere MJ, Zappia JJ, Graham MD. 1993. Titration streptomycin therapy in Ménière’s disease: current concepts. American Journal of Otology. 14:474-477.
Information on this site should not be used as a substitute for talking with your doctor.
Always talk with your doctor about diagnosis and treatment information.
Last updated: 22 Sep 2010