What is the best treatment for Meniere's disease?
Meniere’s disease is a chronic condition that manifests as hearing loss, vertigo, and ringing in the ears. Various surgical options are available for refractory Meniere’s disease that does not respond to medications or if the symptoms of the disease are severe.
The various surgical procedures for Meniere’s disease include:
Endolymphatic sac surgery
The endolymphatic sac plays a role in regulating fluid levels in the inner ear. During the procedure, doctors remove a small amount of bone from around the endolymphatic sac. This helps reduce the pressure of the fluid in the sac.
Labyrinthectomy
Doctors will perform the surgery in either of the two ways:
- Osseous labyrinthectomy (drilling out the bone and removing all labyrinth)
- Destroying some of the soft tissue in the inner ear
The procedure destroys the part of the ear that helps with balancing as well as the part that helps you hear. It is performed only if your hearing power is severely compromised in the ear affected by Meniere’s disease.
Vestibular nerve section/vestibular neurectomy
The procedure involves cutting off nerve fibers (vestibular nerve) that help you to balance. The procedure does not affect your hearing ability.
What makes you unfit for the surgery?
Doctors will evaluate you to know if you are in good health and able to withstand surgery and anesthesia. They will obtain a thorough history and perform a careful physical examination before the procedure. The following conditions are considered as contraindications for the surgery:
- Active otitis media or mastoiditis: Doctors will first resolve these infections, and then, they will go ahead with the surgery.
- Bilateral Meniere’s disease is often a contraindication for labyrinthectomy due to the risk of permanent imbalance.
- Poor general health.
What is the success rate of the surgery?
The success rate of the surgery for Meniere’s disease depends on the type of surgery performed. Endolymphatic sac surgery controls vertigo in 6 to 9 times out of every 10 patients. It can improve the hearing over time and carries a low risk of hearing loss as well.
Labyrinthectomy and vestibular nerve sectioning have success rates of about 95-98%. However, they have a greater risk of hearing loss.
Trans tympanic injection of medications is a relatively new surgical approach, and its efficacy is still not established. Success rates near 90% have been reported.
What are the risks of the surgery?
Surgery for Meniere’s disease can cause potentially serious complications, but it is rare. They depend on the type of surgery or approach used. Your doctor will explain the specific risks involved in your surgery. The possible complications include:
- Hearing loss
- Tinnitus
- Dizziness
- Facial paralysis
- Hematoma (pooling of blood)
- Bleeding
- Cerebrospinal fluid (CSF) leakage
- Taste disturbance
- Mouth dryness
- Otitis media
- Otorrhea
- Meningitis
- Headache
Remember, it is normal to experience severe vertigo and imbalance for the first few days after the surgery. Doctors will prescribe you medications to alleviate nausea and vomiting during this time.
QUESTION
See AnswerBogaz EA, Cavallini da Silva AF, Ribeiro DK, et al. Meniere’s Disease Treatment. In: Bahmad F Jr. ed. Up to Date on Meniere's Disease. IntechOpen; 2017. https://www.intechopen.com/books/up-to-date-on-meniere-s-disease/meniere-s-disease-treatment
Top Is There Surgery for Meniere’s Disease? Related Articles
Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
Deafness
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause. Sensorineural hearing loss can be caused by conditions affecting the cochlea, eighth cranial nerve, spinal cord, or brain. Examples of conditions that can lead to sensorineural hearing loss include Meniere's disease, noise-induced hearing loss, hearing loss of aging (presbycusis), nerve injury from syphilis, hearing loss of unknown cause (idiopathic hearing loss), nerve tumors, and drug toxicity (such as aspirin and aminoglycosides).Detecting Hearing Loss in Children
There are many degrees of hearing, from normal hearing to deafness. Many states mandate the testing of newborns before leaving the hospital. The risk factors for hearing loss in children include- a family history of hearing loss,
- frequent ear infections,
- diagnosis of a learning disability,
- syndromes associated with hearing loss,
- speech delay, and
- infectious diseases that cause hearing loss.
- the child not responding to his or her name,
- the child asking for words to be repeated, and
- the child not paying attention to what is being said.
Headache
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.Hearing Loss: Causes of Hearing Loss
Problems with your ears like ear infections can cause signs of hearing loss. This may be sensorineural hearing loss or conductive hearing loss. Learn how loud noises can induce hearing loss, the signs of hearing loss, and different ways you can prevent hearing problems.Hearing Losss Quiz
Can hearing loss be reversed? Take this quiz to find out!Meniere's Disease
Meniere disease (idiopathic endolymphatic hydrops) is an inner ear disorder with symptoms that include vertigo, tinnitus, hearing loss, and the sensation of ear fullness. The primary treatments for Meniere's disease are diuretics, anti-vertigo, anti-nausea, and low-salt diets. Surgery may be recommended if the vertigo cannot be controlled with medication.Migraine or Tension Headache? Symptoms, Triggers, Treatments
What does a migraine headache feel like compared to a tension headache? Learn to spot migraine symptoms early, how to identify your triggers, and get more information on migraine headache medications and treatments. Learn to tell migraine from other types of headaches.Noise-Induced Hearing Loss
Noise-induced hearing loss may be an acoustic trauma, which causes temporary hearing loss, or it may be permanent due to an acute acoustic trauma. Experts agree that continual exposure to more than 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.Non-Drug Migraine Help
Learn about 14 non-drug treatments for migraines. Acupuncture, biofeedback and massage therapy are among this list of non-drug migraine treatments that may help ease pain.Tinnitus
Tinnitus is described as a throbbing, ringing, clicking, or buzzing in one or both ears. Tinnitus is caused by trauma to the ear, overexposure to loud noises, medication, and diseases or infections of the ear such as multiple sclerosis, TMJ, autistic neuroma, Meniere's disease, hearing loss, and aging. Treatments include medication, tinnitus masking, retraining therapy, and relief therapy.Tinnitus Quiz
Is tinnitus just a nuisance or a symptom of a serious medical condition? Take the Tinnitus Quiz to find out!Tinnitus Slideshow
What is tinnitus? Explore tinnitus (ringing in the ears) causes, symptoms, relief remedies, treatments and prevention tips. Learn about pulsatile tinnitus.How Do You Get Rid of Ringing in the Ears (Tinnitus)?
Tinnitus is not a condition in itself, but a symptom of some other condition that causes a high-pitched whine, a ringing, buzzing or clicking in the ears. It can come from any number of problems starting with the eardrum and cochlea – the organs that turn sound waves into electrical signals for the brain to interpret as sound.What Is the Most Effective Treatment For Tinnitus?
Tinnitus is the perception of abnormal sounds in the ears. Tinnitus may sound like ringing, bussing, roaring, clicking, hissing, or humming in one or both ears. Tinnitus is not a disease itself. Tinnitus is usually a manifestation of an underlying condition, such as age-related hearing loss, ear injury, or circulatory system disorder. However, in many cases, there is no identifiable cause.