Ménière's Disease Treatment

Lifestyle Modifications

Reduce symptom frequency and severity, improve overall well-being, and prevent injury during attacks.

• Keep prescribed medicines for acute attacks with you at all times for immediate relief.
• Maintain a low-salt diet to help reduce fluid retention in the inner ear, which can alleviate symptoms.
• Avoid triggers such as caffeine, alcohol, and nicotine, as these can exacerbate Ménière's symptoms.· Caffeine can increase tinnitus and vertigo.· Alcohol can affect fluid balance and inner ear function.· Nicotine restricts blood flow to the inner ear.
• Stay well-hydrated by drinking plenty of fluids throughout the day.
• Practice relaxation techniques and consider counselling to manage stress and anxiety related to the condition.
• Exercise caution with activities like swimming, climbing ladders, or operating dangerous machinery due to the risk of sudden vertigo.
• Do not drive if experiencing dizziness or the onset of vertigo symptoms, and inform the relevant driving authorities (e.g., DVLA).

Medicinal Treatment

Alleviate acute symptoms, prevent future attacks, manage chronic issues like hearing loss and tinnitus, and improve balance.

• Acute Attack Medications: Prescribed drugs like antiemetics (e.g., prochlorperazine) for nausea and vomiting, and vestibular suppressants (e.g., meclizine, benzodiazepines) to reduce vertigo.
• Prophylactic Medications: Diuretics (e.g., hydrochlorothiazide, triamterene) to reduce fluid pressure in the inner ear, and betahistine to improve inner ear blood flow and reduce attack frequency.
• Intratympanic Injections: Steroids (e.g., dexamethasone) to reduce inflammation, or gentamicin to selectively ablate vestibular function in severe, unilateral cases, reducing vertigo attacks.
• Hearing Aids: To compensate for progressive hearing loss and improve communication.
• Tinnitus Management: Therapies such as Tinnitus Retraining Therapy (TRT) or cognitive behavioral therapy (CBT) to help patients cope with persistent ringing in the ears.
• Vestibular Rehabilitation Therapy (VRT): Exercises designed to help the brain compensate for inner ear imbalance and improve balance and stability.

Surgical Treatment

Provide relief for severe, debilitating symptoms unresponsive to conservative treatments, particularly intractable vertigo.

• Endolymphatic Sac Decompression: A procedure to relieve pressure by draining excess fluid from the endolymphatic sac, often involving shunt placement, aiming to preserve hearing.
• Vestibular Neurectomy: Surgical cutting of the vestibular nerve to stop vertigo signals from the affected ear to the brain, typically preserving hearing in the affected ear.
• Labyrinthectomy: Removal of the balance portion of the inner ear, usually reserved for severe cases with profound hearing loss in the affected ear, as it results in complete hearing loss in that ear.

Surgical options are typically considered only after all non-surgical treatments have failed to control severe and disabling vertigo.