Meniere's Disease Treatments

Treatment for Meniere's disease begins by a complete perception of the symptoms exhibited by the patient. Although there is no cure for Menieres disease, the symptoms can be treated. Menieres disease is a condition where there is an imbalance of the fluids in the ear. Since there is no known exact cause, the treatment lies on addressing the symptoms of the patient. The symptoms commonly seen are vertigo (spinning sensation), feeling of fullness in the ear, tinnitus (ringing of the ear), and variable hearing loss.

Menieres disease treatment medical intervention is aimed at reducing fluids in the ear. Anti diuretics are administered accompanied by a low salt diet since salt causes water retention. Aside from diuretics, vestibular suppressants to address the vestibular disorder are prescribed to relieve dizziness. Vestibular suppressant helps the brain ignore the abnormal impulses the ear is sending. Some physicians would also prescribe anticholinergics, antihistamines, sedative-hypnotics, diazepam (to relax), anti-emetics (for nausea) and other drugs to alleviate the vertigo accompanied by nausea and vomiting.

Surgery is an option when all possible medical treatments fail to alleviate the suffering of a patient and the vertigo is debilitating. It is important to preserve the hearing of the patient so the type of surgery will depend in the degree of hearing loss in the ear that is affected. There are four types of surgery to choose from:

•  Endolymphatic Sac Decompression - this type of surgery is intended to preserve hearing. A cut is made at the back of the affected ear and the mastoid air cells are detached to expose the inner ear and a cut is made in the endolyphatic sac to drain the excess fluid into the mastoid area. The way the ear reacts to the stimulation differs from every patient. Because an irritation to the ear is brought by the surgery, some patients continue to have ear symptoms and dizziness after several months. Success of the surgery therefore can only be determined after several months.

There is 20% chance that vertigo attacks will remain, 60% chance that vertigo attacks will be controlled, and 20% chance the attacks will worsen. There may be stability in the hearing but it rarely improves and the ringing in the ear may be unchanged. Still there is 2% possibility of total hearing loss in the operated ear but then the vertigo is improved. And since the facial nerve is adjacent to the inner ear, there is also a slight chance of a temporary facial weakness for several days or weeks post operation. It may recuperate totally but not always.

•  Labyrinthectomy – this type of surgery is the option for those with complete hearing loss since it sacrifices all the residual hearing in the ear. General anesthesia is used during surgery and it requires a patient to stay for three to four days in the hospital. Incision is made behind the ear and the mastoid cells removed. The inner ear is then surgically removed. Patients usually feel dizzy after surgery and several days after.

Some may need assistance in taking a bath for a week at home and may take several months before they feel completely well. Intravenous fluids and some medications may be given to address the dizziness post operatively. There is a high chance of controlling the dizziness with this surgery.

•  Labyrinthectomy with Balance Nerve Section – This surgery requires a week of hospitalization and general anesthesia. A cut is made behind the ear, mastoid cells removed and the inner ear removed. A cut is made to the dura (brain covering) of the internal auditory canal exposing the hearing and balance nerves.

The nerves are divided and a tiny piece of fat taken from the abdomen is positioned over the opening to avoid leaking of the spinal fluid. Effects after surgery are the same with labyrinthectomy. A 50% chance of relief from tinnitus and excellent chance of control over the vertigo is noticeable. Transient facial weakness or paralysis may happen post operatively since the balance and hearing nerves are adjacent to the facial nerve. Leaking of spinal fluid and meningitis may also occur.

•  Retrolabyrinthine Balance (Vestibular) Nerve Section – This surgery preserves hearing. It uses general anesthesia and requires hospitalization for a week. A cut behind the ear is made and the mastoid air cells removed. An opening is made in the posterior fossa dura (brain covering) and the eighth cranial nerve (hearing and balance) is identified behind the inner ear. The balance portion of the nerve is identified and selectively cut.

Effects after surgery are similar to labyrinthectomy. There is a probability of leaking spinal fluid or meningitis and a 5% chance of total hearing loss in the affected ear. Temporary paralysis or facial weakness is uncommon but may last several days, weeks or months. But it generally disappears completely.

Whatever treatment option is taken by the patient with Menieres disease, the support of close family members is relatively important. With the symptoms exhibited by the patient during attacks the support given by the family members will help the patient in coping with the disease.