Meniere’s syndrome

Abstract

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.

Selective Microsurgical Vestibular Neurectomy: An Option in the Treatment of Intractable Vertigo and Related Microsurgical Landmarks

“…Different methods for evaluating the results of vertigo, hearing, tinnitus, aural pressure and imbalance have been used. Destruction of the labyrinth is placed in a historical context and should be performed where there is no serviceable hearing in the affected ear or no loss of hearing on the other side [1]. Bilateral involvement of the disease is a relative contraindication for destructive procedures.…”

“…Intractable vertigo attacks are included as a small group of patients complaining of dizziness. Vertigo is the most debilitating and resistant symptom of the disease [1]. Most patients with intractable vertigo are generally presented to otorhinolaryngology clinics and initial treatment consists of salt restriction, vestibular sedatives and possibly the addition of thiazide diuretics [1].…”

“…Vertigo is the most debilitating and resistant symptom of the disease [1]. Most patients with intractable vertigo are generally presented to otorhinolaryngology clinics and initial treatment consists of salt restriction, vestibular sedatives and possibly the addition of thiazide diuretics [1]. When medical treatment fails many other surgical choices have been performed like endolymphatic shunting operations and labyrinthine destructive procedures [2].…”