Treatment options for Ménière's disease

There is no cure for Ménière’s disease; treatment is only available to alleviate symptoms of the disorder. 

Treatment usually depends on the patient's severity of dizziness (vertigo).

For patients with mild hearing loss and minimal dizziness, conservative or symptomatic treatment is most reasonable. This generally includes the usage of Gravol (occasionally Valium) to control the symptoms of nausea, which often accompany a patient's dizziness.

Lifestyle modifications and reduction of stress may also have a direct impact on a patient's symptoms. A low-salt diet is usually recommended, but has little scientific basis.

Non-surgical treatment options

1. Diuretics (water pill)
   • E.g. Dyazide
   • ~50 per cent of patients experience some benefit
   • It has several side effects; consult your physician

2. SERC (histamine derivative)
   • Is promoted as an inner ear vasodilator, but has no proven efficacy
   • Few side effects - mostly related to the gut

3. Type of antihistamine
   • E.g. Antivert, Bonamine
   • May have an antinauseant effect

Surgical treatment options

Surgical treatments for Ménière’s disease are reserved for conditions that are incapacitating and unresponsive to medical therapy.

Treatment options include:

1. Gentamicin injection
• Gentamicin is injected through a tube traversing the ear drum
• Destroys the balance portion of the inner ear, thereby getting rid of the origin of vertigo attacks
• Works 85 per cent of the time
• 15 - 50 per cent risk of severe hearing loss in treated ear depending on the treatment regiment
  
  
2. Endolymphatic sac decompression
   • 60 - 65 per cent chance of realizing symptomatic improvement
   • Tries to change inner ear fluid dynamics by opening the sac draining inner ear fluid 
   • Generally reserved for those not wanting to risk hearing

2. Vestibular neurectomy
   • Intracranial operation that cuts the balance nerve altogether
   • 95 per cent success rate with ~5 per cent hearing loss; nevertheless an operation with possible serious consequences

3. Labyrinthectomy
   • In those with very bad hearing, this procedure offers the best control of vertigo
   • The inner ear is completely destroyed; hearing is sacrificed

4. Steroid Injection
   • Could be considered based on the patient’s response to other therapies