Treatment Options for Meniere's Disease

Goals of Treatment of Meniere's Disease

Although there is no cure for Meniere's disease, there are many treatments available for individual symptoms, especially vertigo, the single symptom that patients report being the most disruptive aspect of Meniere's disease. The goal of treatment is to relieve the symptoms and to help the patient achieve as little disruption of daily activities as possible. Some patients note improvement of hearing loss as vertigo is better controlled but this is not predictable nor the focus of the treatment. While some patients experience a spontaneous remission or cessation of symptoms that can last weeks, months, or years, there is no way of predicting who will go into remission or how long the duration of remission will last.

Controversy continues regarding reports of efficacy of treatments used to control vertigo (except for ablative surgical procedures) since Meniere's disease by nature is characterized by fluctuating symptoms. This makes it difficult to determine if improvement of symptoms seen in studies about various treatment options is due to the natural course of Meniere's disease or to the treatment itself. In addition, many studies have proven that there is a strong placebo effect in patients with Meniere's disease which adds to the difficulty in proving the efficacy of treatments.

All treatments for Meniere's disease are focused on treating the symptoms and are prophylactic (try to prevent further attacks), rather than curative. There is no single treatment that is effective for everyone, and each patient must try to identify the treatment that works best for them taking into consideration the symptoms that interfere the most with daily life. Psychological support is helpful for patients as it helps them learn to better cope with symptoms and their impact on quality of life.

In general, the treatment options for Meniere's disease include:

• Reducing levels of endolymphatic fluid
• Medical (drug) therapy
• Meniett device
• Surgical therapy to control vertigo attacks
• Control of tinnitus