Surgical Treatment of Dizziness & Meniere’s Disease
Meniere’s disease is a prominent cause of recurrent dizziness attributed to the inner ear. For those patients who suffer from the disease, the symptoms can be life altering and dramatically affect one’s ability to function in normal daily living. The treatment of Meniere’s disease has evolved over many years. New, minimally invasive techniques utilizing endoscopes and/or lasers have become available, are generally well tolerated, and even allow the patient to self-treat the inner ear under the direction of the neurotologic physician.
Once a diagnosis of Meniere’s disease is established, non-surgical treatments are attempted as first-line therapy to control the vertigo and other symptoms. Lifestyle modifications are recommended, including a low salt diet, reduction/avoidance of caffeine and alcohol, and control of stress. Medications such as a diuretic (water pill) may be prescribed to eliminate excess fluid. Since Meniere’s disease can be precipitated by environmental and food allergies, allergy testing and treatment are often recommended. While medications can be given during times of disabling vertigo episodes (e.g. Meclizine/Antivert, Phenergan, and Valium), it is best to otherwise avoid vertigo suppressant medications since they can delay overall recovery. Vestibular rehabilitation by a specially trained therapist has been proven to be extremely useful in speeding recovery and improving balance.
For many sufferers of Meniere’s disease, reasonable control of the symptoms can be attained with medical therapy as described above. However, for some individuals adequate relief cannot be achieved without surgical intervention. Several surgical alternatives exist which vary in invasiveness, affects on hearing, and rate of success. Surgical options include Gentamicin treatment of the inner ear, endolymphatic sac surgery, vestibular neurectomy, and labyrinthectomy. Your physician will determine surgical options based largely upon the severity of the vertigo and other Meniere’s symptoms, hearing status, condition of the unaffected ear, and overall medical status. If Meniere’s disease is present in both ears, surgical treatment is typically not used due to the possibility of complete loss of vestibular and/or hearing function in both ears.