Ménière’s Disease

About Ménière’s Disease Treatments

Detail – Ménière’s disease treatment often begins with lower risk therapies to manage symptoms before employing invasive or destructive surgery

Ménière's disease is an idiopathic, complex inner ear disorder that has no cure. Ménière's disease progresses differently in each patient, and not every patient responds to the same approach. For some, Ménière’s disease will improve with or without treatment. For others, symptoms of Ménière’s disease will progressively worsen.

Generally, the treatment goal is to manage Ménière's disease symptoms at an acceptable level using the most conservative method. Many physicians follow the Ménière's disease treatment ladder, trying lower risk therapies for Ménière's disease before more invasive or destructive surgery.¹

There is much research on Ménière's disease and its treatments. We encourage physicians and patients to further their knowledge and understanding of this complicated disorder.

Functionality and Quality of Life in Ménière's Disease

Detail – AAO-HNS Ménière’s Disease Functional Level Scale¹⁴

Functionality level is an important indicator of a Ménière's disease patient's quality of life. Ménière’s disease symptoms are often unpredictable, and some Ménière's disease patients experience sudden vertigo attacks so severe that they live in constant fear of another attack. This can be very disabling for Ménière's disease patients, significantly reducing quality of life.¹³

The AAO-HNS has a self-assessed, six-point functional level scale that can help you determine the effect of vertigo symptoms on your Ménière's disease patients.¹⁴

Download the AAO-HNS Functional Level Scale.

Diet/Lifestyle and Medical Therapy

Diet/lifestyle and medical therapy is a first-level treatment for Ménière's disease that is usually prescribed before other Ménière's disease therapies. For some patients, this Ménière's disease therapy effectively manages their symptoms and no other treatments are necessary. This therapy may include a combination of:

• A low-sodium diet, diuretic therapy, and fluid intake regulation – designed to reduce excess endolymphatic fluid by reducing overall fluid levels in the body^15-17
• Avoiding stress, tobacco, alcohol, and caffeine – known to exacerbate Ménière's disease symptoms^15-17
• Prescription medications – may include steroids, antidepressants, antihistamines, anti-vertigo and vasoactive drugs, as well as other medications^15-17

We offer information for patients about this Ménière's disease therapy, including tips for monitoring salt intake and website links to other resources.

Meniett Micropressure Therapy

Medtronic’s Meniett^® device offers a second-level treatment that is safe, simple, and effective for managing the dizziness and vertigo symptoms of Ménière’s disease.^1-12 The Meniett device:

• Has been developed and tested in nearly 30 years of clinical research in the US and abroad, including placebo-controlled studies^1-12,18-22
• Is a small, portable micropressure therapy system, a type of treatment supported by the AAO-HNS for certain cases of Ménière’s disease, especially after diet/lifestyle and medical therapy fails²³
• Is easy and convenient for Ménière’s disease patients to use just about anywhere
• Is most effective for patients whose worst symptom is vertigo, often the most debilitating effect of Ménière’s disease

Once they begin Meniett therapy, most patients know within 6 weeks if their Ménière's disease will respond to this treatment. A small number of patients don't respond, so Medtronic offers a full refund if the device is returned within the 6-week trial period. If Meniett therapy is discontinued, other Ménière's disease treatments can still be employed.

You can send your patients to Meniett.com to learn more about Ménière's disease, the Meniett device, and other Ménière's disease treatments.

Surgical and/or Destructive Therapy

Surgical and/or destructive therapy is considered a third-level treatment for Ménière's disease. These therapies offer varying levels of effectiveness but are more invasive procedures with higher risk. Destructive therapies that destroy some or all of the inner ear’s auditory and vestibular functions are irreversible.

Many Ménière's disease patients prefer to avoid more invasive surgical or destructive treatments, so they’re usually suggested only after more conservative Ménière’s disease therapies have failed. Surgical or destructive Ménière’s disease treatments include:

• Endolymphatic sac surgery – may include implanting a shunt in the affected ear to drain excess endolymphatic fluid or surgically “damaging” the endolymphatic sac
• Vestibular neurectomy – vestibular nerve section in the affected ear
• Labyrinthectomy – surgical removal of the labyrinth that permanently destroys the hearing and balance functions of the operated ear; usually only performed if most of the patient’s hearing in that ear is already lost
• Intratympanic injections (chemical labyrinthectomy) – ototoxic gentamicin or corticosteroids are injected through the eardrum into the middle ear space of the affected ear

Information for patients about surgical and/or destructive therapy for Ménière's disease is available also on this website.