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Surgical or Destructive Therapy

Surgical or destructive Ménière's disease therapies may be recommended when less risky Ménière's disease treatments fail to help. Some surgeries try to improve how your inner ear absorbs fluid or reduce the fluid it produces. Other Ménière's disease surgical treatments try to reduce dizziness and vertigo by decreasing the balance function of your inner ear.

> Detail – See the swollen hearing and
 balance canals in Ménière's disease

Destructive Ménière's disease treatments destroy or deaden some or all of your inner ear. These procedures are irreversible. In most cases, your other ear will compensate for this loss, as long as it’s not affected by Ménière's disease or other conditions.

All surgery involves risks, and some procedures are more risky than others. Be sure to ask your physician about the potential benefits, risks, and side effects of any Ménière's disease treatment.

Endolymphatic Sac Surgery

The endolymphatic sac produces endolymph, the fluid that circulates in your inner ear. Ménière's disease patients have too much endolymph, which increases pressure in the ear and causes Ménière's disease symptoms.

This Ménière's disease surgery is designed to increase drainage from the inner ear and relieve the pressure. It may include implanting a shunt to drain the excess fluid or surgically “damaging” the endolymphatic sac. The effectiveness of this Ménière's disease treatment varies.^1,2

Vestibular Nerve Section/Neurectomy

The vestibular (balance) nerve extends from the inner ear to the brain. In this procedure, the surgeon cuts the balance nerve in the ear that is affected by Ménière's disease.

Cutting this nerve reduces the inner ear’s balance function to control vertigo symptoms of Ménière's disease. The procedure is often effective for stopping vertigo attacks,³ but it is a more serious operation.

Ear Injections

This Ménière's disease treatment is intended to reduce dizziness and vertigo symptoms by making the inner ear work less effectively. Antibiotics or corticosteroids are injected through the eardrum into the middle ear so they can be absorbed by the inner ear.^4,5

The most commonly used antibiotic for this Ménière's disease treatment is gentamicin, which is toxic to the inner ear. Gentamicin injections decrease the inner ear’s ability to perform its balance function. It may also cause additional hearing loss.

Corticosteroids are also sometimes used as a Ménière's disease treatment, injected the same way as gentamicin. This seems to be somewhat less effective at reducing vertigo, but has a lower risk of hearing loss as well.

Labyrinthectomy

A labyrinthectomy is usually only performed if you’ve already lost most of your hearing in the ear with Ménière's disease. This Ménière's disease treatment involves surgically removing some or all of the hearing and balance canals of your inner ear (the area called the labyrinth).

The hearing and balance functions of the operated ear are permanently destroyed. Your other ear can provide hearing and balance, assuming it is healthy and not affected by Ménière's disease or other conditions.

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