Meniere's Syndrome

The primary goals of treatment in Meniere's syndrome are to control attacks of vertigo and, if possible, to arrest the progression of hearing loss. Initial treatment consists of rigid dietary sodium restriction, possibly with the addition of a thiazide diuretic. If disabling attacks of vertigo persist despite sodium restriction, surgical intervention should be considered. Endolymphatic shunting is an option for patients who desire a less invasive surgical remedy, but recurrence of vertigo occurs in about 40% of cases. Vestibular nerve ablative surgery is the definitive surgical treatment for patients with intractable attacks of vertigo who still have useful hearing on the affected side. Labyrinthectomy is a surgical option when there is no serviceable hearing in the damaged ear. Intra-aural gentamicin instillation is an option in carefully selected cases.