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OTORINOLARINGOLOGIA

A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery


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Otorinolaringologia 2011 December;61(4):111-26

language: English

Meniere’s disease from pharmacotherapy to surgery

Espinosa-Sanchez J. M. 1,2, Lopez-Escamez J. A. 1,3

1 Otology and Neurotology Group CTS495, Genomics and Oncologic Investigation Center, Pfizer Universty of Granada, Granada, Spain
2 Department of Otolaryngology, Hospital San Agustín, Linares, Jaén, Spain.
3 Department of Otolaryngology, Poniente Hospital, El Ejido, Almería, Spain


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Meniere’s disease (MD) is an inner ear disorder of unknown etiology characterized by recurrent vertigo, sensorineural hearing loss, tinnitus and aural fullness. The aim of the treatment is to reduce the frequency and duration of episodes of vertigo and there is no treatment able to prevent hearing loss progression or bilateral affectation. We review the management and treatment of MD including drugs used to control the acute spells of vertigo. The baseline treatment consist of lifestyle modifications to prevent the recurrence of episodic vertigo, but diverse treatment options are summarized such as betahistine, diuretics, systemic steroids and intratympanic gentamicin or steroids. The indication for surgery in MD should be personalized and it is limited to failure of medical therapies. Surgical techniques for MD include endolymphatic sac surgery, labyrinthectomy, vestibular neurectomy and cochlear implantation. Some devices using pressure or laser radiation delivered to the ear drum are also mentioned, but most of the treatments do not have a strong level of evidence to be recommended. We present general guidelines and a stepwise approach for conservative management of vertigo in patients with MD. Finally, new perspectives under research to treat MD are briefly described including the administration of nanoparticles containing neurotrophic factors or stem cells approach.

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