There are two different therapeutic approaches for Ménière’s disease. First, treatment can take place during an attack. Second, different therapeutic measures can be used to prevent the next attack or at least to reduce the number of occurrences. Depending on the severity of Ménière’s disease, a doctor will determine which treatment is needed.
Below you will find the different treatment options for Ménière’s disease. These include the attack reduction therapy, the interval therapy, and surgery. Below you will also find more information about preventing Ménière’s disease.
Attack reduction therapy
This option only treats the symptoms, not the cause itself. Doctors refer to this as a symptomatic treatment. Typical symptoms of Ménière’s disease include tinnitus, hearing loss, and vertigo. In an acute attack situation, tinnitus can be treated with simple diet changes and prescription drugs.
The dizziness can be treated with antivertiginous (stops dizziness) and antiemetic (stops vomiting) drugs. The preferred drug is dimenhydrinate, which inhibits the H1 receptors in the vomiting center of the central nervous system, thus relieving nausea and dizziness. Additionally, bed rest is highly recommended. If an attack includes frequent vomiting, plenty of fluids should be drank to compensate for the loss of liquids and electrolytes.
Prevention of further attacks
To further prevent Ménière’s disease attacks, one should avoid as much as possible psychologically stressful situations. Moreover, making sure your blood pressure is normal with the help of doctor is crucial to avoid a drop in blood pressure (hypotension). Treatment of the cervical spine may also be helpful.
Interval therapy is a treatment that takes place between attacks. Betahistine is typically used for this kind of therapy, and it is also effective against dizziness. It is still uncertain whether this drug has a positive effect on people with Ménière’s disease. However, doctors still prescribe it regularly as a form of treatment.
Surgical treatment measures
If Ménière’s disease cannot be treated with a form of drug therapy, the only remaining option is surgery. There are two types of surgery:
1. The first is the severing of the respective balance nerve (vestibular nerve). Doctors speak here of a vestibular neurotomy.
2. The second is the removal of the labyrinth, commonly referred to as a labyrinthectomy. In this method, the vestibule and the hearing organ are removed. This surgery only applies to patients with Meniere’s disease who have already lost their hearing and are deaf.
A less invasive method is intratympanic gentamicin instillation, which is the “elimination” of the labyrinth. Gentamicin is toxic to the inner ear and the labyrinth, destroying them upon contact. Here, the gentamicin goes through the tympanic membrane to the middle ear (intratympanically) and into the inner ear, where the labyrinth is located.
Determining with certainty how long Ménière’s disease will last is not easy. In most cases, the disease is chronic. Attacks can come and go for a few days, months or even years. Dizziness may be more infrequent, and the hearing loss produced by Ménière’s disease may lead to deafness.