Treatment FAQ

which is not a surgical procedure used in the treatment of ménière’s disease?

by Murray Kihn Published 2 years ago Updated 2 years ago

Medication

The various surgical procedures for Meniere’s disease include endolymphatic sac surgery, labyrinthectomy, and Vestibular nerve section/vestibular neurectomy. Meniere’s disease is a chronic condition that manifests as hearing loss, vertigo, and ringing in the ears.

Procedures

A diagnosis of Meniere's disease requires: 1 Two episodes of vertigo, each ... 2 Hearing loss verified by a hea ... 3 Tinnitus or a feeling of fulln ... 4 Exclusion of other known cause ...

Therapy

Intratympanic Steroids Steroids to treat Meniere’s are injected into the inner ear either directly through the eardrum or through a grommet. Injection directly into the inner ear produces a much higher concentration of the drug compared to the steroids being taken orally.

Nutrition

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 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.

What are the different types of surgical procedures for Meniere’s disease?

How to make a diagnosis of Meniere's disease?

How are steroids used to treat Meniere’s?

What are the treatment options for refractory Meniere’s disease?

Does surgery work for Meniere's disease?

Surgery to Destroy the Balance Organ Through an incision behind the ear, a portion of the mastoid bone is removed, and the inner ear balance chambers are removed. Vertigo is eliminated in approximately 97 – 98% of cases.

What is the best treatment for Meniere's disease?

Diuretics are the most commonly prescribed maintenance medications for Meniere's disease. Diuretics work by restricting the overproduction of fluid in the inner ear. Diuretics are long-term medications. They help reduce the number of vertigo attacks, and in some cases, they help stabilize hearing.

What are two diagnostic procedures used for Meniere's disease?

Hearing tests, including one to find out if the nerve from the inner ear to the brain is working as it should. A test called an electronystagmogram (ENG), which measures your eye movements. This can help the doctor find where the problem is that's causing vertigo. Imaging tests such as an MRI or CT scan of the head.

What is labyrinthectomy surgery?

What is a labyrinthectomy? A labyrinthectomy is a surgical procedure that is performed to treat vertigo if you have very little hearing in the affected ear. This is a last resort option when it is determined that a hearing aid will not be effective in helping you hear more clearly.

Are there any new treatments for Meniere's disease?

The new drug to relieve the symptoms of tinnitus and sensorineural hearing loss in those with Meniere's disease is on the fast track in the new drug application process. The drug is called SPI-1005 and is a product of the Sound Pharmaceuticals company.

Does a cochlear implant help with Meniere's disease?

The results indicate that cochlear implantation is an option for patients with severe-to-profound hearing loss secondary to Meniere's disease.

Can MRI detect Meniere's disease?

Magnetic resonance imaging (MRI) scan The MRI scan will not confirm a diagnosis of Ménière's disease, nor will it show which ear is affected or how severe the condition is. During initial investigation it is important to exclude many serious conditions which can cause vertigo or unilateral hearing loss and tinnitus.

What is Videonystagmography test for?

VNG is used to find out if you have a disorder of the vestibular system (the balance structures in your inner ear) or in the part of the brain that controls balance.

What is Intratympanic steroid injection?

Intratympanic steroid injection is used to treat cochleovestibular symptoms of inner ear disease, such as Meniere's disease or idiopathic sudden sensorineural hearing loss. This procedure involves using a syringe needle to penetrate the tympanic membrane to inject the steroid into the middle ear.

What is a Stapedectomy surgery?

Stapedectomy — the surgical removal of the stapes and insertion of a prosthesis — was first introduced at Mount Sinai in the 1950s. At Mount Sinai we perform many stapedectomy operations each year, with excellent results. An alternative to stapedectomy is the use of a hearing aid.

What is vestibular surgery?

A vestibular nerve section is a destructive surgery used for Ménière's disease. The vestibular branch of the vestibulo-cochlear nerve is cut in one ear to stop the flow of balance information from that ear to the brain. The brain can then compensate for the loss by using only the opposite ear to maintain balance.

What is cochlear implant surgery?

Cochlear implants use a sound processor that fits behind the ear. The processor captures sound signals and sends them to a receiver implanted under the skin behind the ear. The receiver sends the signals to electrodes implanted in the snail-shaped inner ear (cochlea).

Treatment

Mechanism of action

Cause

Prognosis

Medically reviewed by
Dr. Mansi Shah
Your provider will work with you to develop a care plan that may include one or more of these treatment options.
The treatment includes medication, surgery or rehabilitation therapy to reduce episodes of vertigo, and hearing loss.
Medication

Motion sickness medications: Helps control the episodes of vertigo.

Meclizine . Diazepam


Antinausea medications: To prevent nausea and vomiting.

Promethazine


Diuretics: To reduce fluid retention. It is usually prescribed with reduced dietary salt intake.

Chlorthalidone . Furosemide . Hydrochlorothiazide


Middle ear injections: To reduce episodes of vertigo.

Gentamicin . Dexamethasone

Procedures

Endolymphatic sac procedure: Decompression can be brought about by removing the overlying bone, making an incision in the dura or stenting it open.

Vestibular nerve section: Vestibular nerve is removed. This helps in correcting vertigo and also maintaining the hearing in the affected ear.

Labyrinthectomy: Portion of the ear which controls balance is removed, usually done upon total hearing loss in the affected ear.

Therapy

Hearing aid:To improve hearing in the affected ear.

Vestibular rehabilitation therapy:In case experiencing imbalance, to improve balance, Usually recommended in severe cases.

Nutrition

Foods to eat:

  • Low sodium food like fresh fruits or vegetables

Foods to avoid:

  • Canned foods as it contains high salt or sodium content
  • Processed foods like cured or smoked meats, bacon, hot dogs and sausage
  • Packaged foods like macaroni cheese and rice mixes
  • Snack foods like chips or crackers

Specialist to consult

Otolaryngologist
Specializes in the diagnosis and treatment of diseases of the ear, nose and throat.
Neurologist
Specializes in treating diseases of the nervous system, which includes the brain, the spinal cord, and the nerves.

Pathophysiology

Risks

  • This involves a very strong type of cortisone drug named Dexamethasone. The exact mechanism and reason why this treatment works is not totally understood, but when the drug passes into the inner ear through the round window membrane, either through anti-inflammatory effect or other unknown effect, it results in control of the vertigo attacks in most patients, and it may also impr…
See more on earsurgery.org

Mechanism

  • The actual cause of the fluid accumulation in the inner ear, the condition which sets off the whole process to begin with in Menieres Disease, is not known. In animals, experiments have been done which show that if the sac that drains fluids from the inner ear is tied off, fluid will build up in the inner ear and cause changes comparable to those in humans. Because of the observation of flui…
See more on earsurgery.org

Diagnosis

  • In theory, the endolymphatic sac operation should decompress the excessive fluid within the inner ear chambers and allow the inner ear to re-equilibrate, taking pressure off the nerve endings of hearing and balance. Studies have shown little positive effect on hearing from drainage of the endolymphatic sac. ESD often does NOT cure Menieres sufferers. Vertigo subsides after surger…
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Treatment

  • The two inner ear balance centers can be thought of as gyroscopes. The gyroscope of each ear helps to control balance by sending signals of the position we are in to the brain. If one gyroscope is faulty, as is the case in Menieres, the brain has trouble adapting, since it is intermittently getting wrong signals mixed with correct ones. However, if the inner ear balance nerve is completely sh…
See more on earsurgery.org

Lifestyle and Home Remedies

  • Labyrinthectomy does not spare any residual hearing. In a young individual, surgery that conserves the remaining hearing in the ear affected by Menieres is most important. A certain percentage of young people with Menieres may also develop the illness in their opposite ear later in their lifetime: 10 to 20 percent.
See more on earsurgery.org

Coping and Support

  • Vestibular neurectomy involves the discrete sectioning of the nerve of balance near where it comes out of the brain. The hearing portion of the nerve is thus preserved. Ninety to 95 percent of vestibular neurectomies will result in cure of vertigo.
See more on earsurgery.org

Preparing For Your Appointment

  • Your doctor will conduct an exam and take a medical history. A diagnosis of Meniere's disease requires: 1. Two episodes of vertigo, each lasting 20 minutes or longer but not longer than 12 hours 2. Hearing loss verified by a hearing test 3. Tinnitus or a feeling of fullness in your ear 4. Exclusion of other known causes of these problems
See more on mayoclinic.org

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