Pressure treatment versus gentamicin for Meniere's disease

Ménière's disease may be treated in different ways. After obtaining a case history and performing auditory and vestibular tests the diagnosis should be obvious. In terms of treatment, the first steps are to provide the patient with information, institute a low-salt diet and regulate internal medical disorders. The next step is pharmacological treatment using diuretics, betahistine and other drugs. Local pulsated pressure treatment in the ear canal has been used in a placebo-controlled study and showed significant improvement, primarily of vertigo, but also in terms of tinnitus and hearing. Hence, this form of treatment can be used in some phases of the disease. In more severe cases gentamicin treatment has proved successful; in the present study, vertigo was cured in all but 3 of 35 patients. On average, no extra hearing loss was caused: however, one ear became deaf, some ears showed improvement and some ears showed a certain degree of hearing loss. In cases of escalation of Ménière's disease, pressure treatment should be used initially, followed by gentamicin. These two methods of treatment are not in competition as they are used to treat different stages of the disease.