How is Ménière’s disease treated?

Although there is no cure for Ménière’s disease, the attacks of vertigo can be controlled in nearly all cases. Treatment may include:
A low salt diet and a diuretic (water pill), Anti-vertigo medications, Intratympanic injection with either gentamicin or dexamethasone, An air pressure pulse generator, or Surgery.

Your otolaryngologist will help you choose the treatment that is best for you, as each has advantages and drawbacks. In many people, careful control of salt in the diet and the use of diuretics can control symptoms satisfactorily.

When is surgery recommended?
Surgery is needed in only a small minority of patients with Meniere’s disease. If vertigo attacks are not controlled by conservative measures and are disabling, one of the following surgical procedures might be recommended:

• Endolymphatic sac shunt or decompression procedure relieves attacks of vertigo in one-half to two-thirds of cases and the sensation of ear fullness is often improved. Control is often temporary. Endolymphatic sac surgery does not improve hearing, but only has a small risk of worsening it. Recovery time after this procedure is short compared to the other procedures.

• Selective vestibular neurectomy is a procedure in which the balance nerve is cut as it leaves the inner ear and goes to the brain. While vertigo attacks are permanently cured in a high percentage of cases, patients may continue to experience imbalance. Similar to endolymphatic sac procedures, hearing function is usually preserved.

• Labryrinthectomy and eighth nerve section are procedures in which the balance and hearing mechanism in the inner ear are destroyed on one side. This is considered when the patient with Ménière’s disease has poor hearing in the affected ear. Labryrinthectomy and eighth nerve section result in the highest rates for control of vertigo attacks.

Source: American Academy of Otolaryngology- Head and Neck Surgery, Inc.

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