No cure exists for Meniere's disease, but a number of treatments can help reduce the severity and frequency of vertigo episodes. There are no treatments for the hearing loss that occurs with Meniere's disease. All of the treatments — some conservative, some aggressive — are to stop the spells of vertigo.
Medications for vertigo
Your doctor may prescribe medications to take during a vertigo episode to lessen the severity of an attack:
- Motion sickness medications, such as meclizine or diazepam (Valium), may reduce the spinning sensation and help control nausea and vomiting.
- Anti-nausea medications, such as promethazine, might control nausea and vomiting during an episode of vertigo.
Long-term medication use
Your doctor may prescribe a medication to reduce fluid retention (diuretic). For some people, a diuretic helps control the severity and frequency of Meniere's disease symptoms. A diuretic is usually combined with limiting dietary salt intake.
Noninvasive therapies and procedures
Some people with Meniere's may benefit from other noninvasive therapies and procedures, such as:
- Rehabilitation. If you have balance problems between episodes of vertigo, vestibular rehabilitation therapy might improve your balance.
- Hearing aid. A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your doctor can refer you to an audiologist to discuss what hearing aid options would be best for you.
Meniett device. For vertigo that's hard to treat, this therapy involves applying pressure to the middle ear to improve fluid exchange. A device called a Meniett pulse generator applies pulses of pressure to the ear canal through a ventilation tube.
You do the treatment at home, usually three times a day for five minutes at a time. Initial reports on the Meniett device show improvement in symptoms of vertigo, tinnitus and aural pressure, but its long-term effectiveness has not been determined.
If the conservative treatments listed above aren't successful, your doctor might recommend some of these more aggressive treatments.
Middle ear injections
Medications injected into the middle ear, and then absorbed into the inner ear, may improve vertigo symptoms:
- Gentamicin, an antibiotic that's toxic to your inner ear, reduces the balancing function of your ear, and your other ear assumes responsibility for balance. The procedure, which can be performed during local anesthesia in your doctor's office, often reduces the frequency and severity of vertigo attacks. There is a risk, however, of further hearing loss.
- Steroids, such as dexamethasone, also may help control vertigo attacks in some people. This procedure can also be performed with local anesthesia applied by your doctor. Although dexamethasone may be slightly less effective than gentamicin, dexamethasone is less likely than gentamicin to cause further hearing loss.
If vertigo attacks associated with Meniere's disease are severe and debilitating and other treatments don't help, surgery might be an option. Procedures include:
Nov. 26, 2015
Endolymphatic sac procedure. The endolymphatic sac plays a role in regulating inner ear fluid levels. These surgical procedures may alleviate vertigo by decreasing fluid production or increasing fluid absorption.
In endolymphatic sac decompression, a small portion of bone is removed from over the endolymphatic sac. In some cases, this procedure is coupled with the placement of a shunt, a tube that drains excess fluid from your inner ear.
- Vestibular nerve section. This procedure involves cutting the nerve that connects balance and movement sensors in your inner ear to the brain (vestibular nerve). This procedure usually corrects problems with vertigo while attempting to preserve hearing in the affected ear. It requires general anesthesia and an overnight hospital stay.
- Labyrinthectomy. With this procedure, the surgeon removes the balance portion of the inner ear, thereby removing both balance and hearing function from the affected ear. This procedure is performed only if you already have near-total or total hearing loss in your affected ear.
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