Because the treatment of Ménière’s disease concentrates on dealing with the symptoms rather than the cause (which is unknown), the exact treatment varies according to the specific needs of each individual.
Treatment may include medication, vestibular rehabilitation (exercises designed to improve balance and reduce dizziness), changes in diet and lifestyle, tinnitus management, hearing aids and counselling. For most people, non-surgical measures carried out under the guidance of an ENT consultant, are usually effective enough to control the symptoms. However, if vertigo is still a problem then surgical procedures may help.
The type of surgery you have will depend on your exact symptoms and their severity, and whether both ears are affected. Surgical procedures include; non-destructive surgery; selectively destructive surgery; and destructive surgery.
This surgery aims to reduce the frequency and severity of your symptoms. The different types of non-destructive surgery include:
- endolymphatic sac decompression, which helps reduce the pressure in the inner ear by increasing the drainage of fluid
- insertion of ventilation tubes (grommets) which reduce the changes in pressure that cause Ménière's disease
- injecting steroid medication through the eardrum
- micropressure therapy - a new treatment where grommets are inserted into your ear and attached intermittently to a small pressure generator to alter the pressure in the inner ear
Selectively destructive surgery
This surgery aims to destroy the balance part of your inner ear with a medicine called gentamicin which is injected through the eardrum. This should selectively damage the balance part of your ear, but there's a small risk it could damage your hearing as well. Some surgeons prefer to control the exact dose of gentamicin that enters your ear by applying it directly to the inner ear during a minor operation.
Destructive surgery may be suggested if only one ear is affected by Ménière's disease. The operation will only be considered if the hearing in the affected ear is judged to be permanently very poor, as the operation will cause permanent hearing loss. The procedure uses destructive surgery to destroy the part of your inner ear causing your vertigo. After surgery, your other ear will take over your balance and hearing functions.
If you’ve had surgery under a general anaesthetic you will need to avoid driving for 24 hours. Generally you’ll be able to resume day to day activities, including work, straight away.
Although there's currently no cure for Ménière's disease, treatment will usually help to control the symptoms you’ve experienced. There are risks to damage of the hearing, balance, sense of taste and the facial nerve.
Treatment options include alternative approaches to controlling the symptoms of Ménière's disease. These will normally be recommended before surgery is suggested and include:
- dietary advice – especially a low-salt diet
- medication (to treat and prevent he symptoms of vertigo, nausea and vomiting experienced during attacks)
- treatment for tinnitus
- treatment for loss of hearing
- vestibular rehabilitation (to improve balance and reduce dizziness)
- treatment for stress, anxiety and depression