Current treatment of Meniere's disease

Abstract

Meniere's disease (MD) is a morbid inner ear disease that manifests disabling symptoms such as episodic vertigo, tinnitus, and fullness in the ear, for which patients seek immediate medical attention. The treatment of disabling vertigo of patients with MD remains controversial. Endolymphatic hydrops of the inner ear is presently considered the pathophysiology for explaining the underlying mechanisms of MD. There are many therapeutic options for MD, but no one is considered a highly effective modality for the cure of the MD. The primary purpose of the medical treatment of MD is to treat his or her symptoms rather than disease. Betahistine and diuretics are usually effective medical treatments for controlling vertigo in MD. However, there is no proven medical therapy for hearing loss or evolution of the disease in MD. There are several reports in favor of intratympanic use of aminoglycosides for the control of vertigo. Endolymphatic sac decompression is a surgical treatment option in the case of medically intractable MD. Vestibular neurectomy and labyrinthectomy are two important surgical techniques for the treatment of disabling vertigo of MD, but these surgical procedures are associated with relatively higher surgical morbidity. Recently, treatment with chemical labyrinthectomy/transtympanic gentamycin injection and endolymphatic sac decompression have gained favor for MD because they have less invasive techniques and are associated with fewer risks and side effects. The objective of this review article is to discuss current treatment options for MD to relieve disabling symptoms of MD and so improving the quality of life.