Raleigh, NC 27609
Monday - Friday
8:30am to 5:00pm
Medical Treatment of Meniere’s Disease
Meniere’s disease is present when a triad of symptoms exists: fluctuating hearing loss, episodic tinnitus (correlated to attacks), and episodic vertigo (a sense of spinning or motion) accompanied in many instances with nausea and vomiting. It can be one of the most difficult disorders to live with and requires treatment at specialized centers. Thorough medical evaluation is mandatory to identify, treat, or rule out associated diseases or more threatening medical conditions (brain tumors, for example, may masquerade as Meniere’s Disease). Diagnostic evaluation includes and audiogram and potentially a video-infrared electronystagmogram, electrocochleography, posturography, stacked band derived auditory brainstem response, and various radiology imaging studies such as an MRI or CT scan.
Contary to what many patients have been told, Meniere’s Disease is treatable with over 90% of patients seen at CEHC achieving significant or complete relief of symptoms. A three-tiered treatment strategy is utilized with the goal of finding the easiest, most effective treatment for an individual patient. First level therapy may include a combination or dietary and/or lifestyle modification (a low salt diet is used in most patients, for example), diuretic therapy to reduce fluid pressure in the inner ear – the cause of the disorder, treatment of exacerbating medical conditions (such as treatment of environmental allergies, migraines, chronic medical conditions, middle ear conditions and many others), and vestibular suppressant therapy using medications. Approximately 65% of patients respond favorably to first line therapy and need no further treatment. In the remainder of patients, Second line therapy is chosen from three alternatives: Endolymphatic Mastoid Shunt, Intra-tympanic Gentamycin therapy, or the Meniett Device. Less than 5% of patients proceed to third-tier therapy which includes an ablative procedure such as removal of the inner ear balance system (called Labyrinthectomy) which takes away the hearing in the affected ear or to division of the balance nerve which preserves the hearing in the affected ear in most cases (Vestibular Neurectomy). Please see the attached diagram for comparison of second and third tier therapies.