There is no known cure for Meniere’s, although research is being performed here at OSU and at other major medical institutions. However, there is treatment available for the vertigo symptoms:
Low salt diet
A low salt diet is very important for Meniere’s patients, as too much salt can alter the amount of fluid in your inner ear and trigger further attacks. Meniere’s patients should have no more than a total of 1500-1800 mg (milligrams) of salt per day. Typically, it is the hidden salt in our foods that adds up. You will need to start reading food labels to control your sodium intake and in general avoid highly salted foods.
¼ teaspoon = 575 mg of sodium
½ teaspoon = 1,150 mg of sodium
¾ teaspoon = 1,725 mg of sodium (range for Meniere’s patients)
1 teaspoon = 2,300 mg of sodium
Other dietary changes may include avoiding caffeine, chocolate, alcohol and MSG.
Other dietary changes
In addition to the low salt diet, a water pill (diuretic) is often prescribed to keep excess fluid from settling in your inner ear. Our office most commonly prefers to prescribe Dyazide or Maxzide (a combination of Triamterene and hydrochlorothiazide), as this particular diuretic has been studied the most when it comes to Meniere’s patients. Also, it has two components – one that is potassium-sparing and the other sodium-depleting, which is a safer combination overall and has fewer side effects than some other diuretics. However, other diuretics may be prescribed for some patients, as other existing health problems may play a role in what type of diuretic we recommend. We may suggest you work with your primary care physician in adjusting this medication for your needs.
Sometimes an injection of a steroid through the eardrum after it is numbed will temporarily settle down a period of increased Meniere’s activity. This can be done in our office by your ENT specialist.
Another type of injection performed in the office is called a Gentamicin injection (“gent injection”), which is used to chemically destroy the inner ear. Gentamicin is a strong antibiotic given through an IV that is used for patients who have life-threatening infections. This antibiotic has a side effect known as ototoxicity (poisonous to the ear), but this side effect has been found to be helpful in Meniere’s patients when it is injected directly through the numbed eardrum and allowed to travel into the inner ear structure. Some patients require numerous gent injections over a period of many weeks or months, and frequently, a severe attack occurs as a result of the inner ear “dying off,” which is the intended goal of the treatment. The gent injections will not improve hearing, tinnitus or ear fullness and are intended only to control vertigo. Gent injections are not recommended for all Meniere’s patients. But if this treatment is recommended in your case, you should discuss the pros and cons with your physician.
The most common surgical procedure in our practice to treat Meniere’s is an endolymphatic sac decompression and shunt surgery. This is usually performed as an outpatient surgery, in which you go home the same day.
The surgery itself takes about two hours. The inner ear is approached via an incision behind the ear and through the mastoid to place a shunt or drain inside the inner ear to regulate your inner ear fluid.
Most people are off work two to three weeks after the surgery.
Many people must still continue their low salt diet and water pill after surgery. Although you may have some improvement in your other symptoms, the main goal is to control your vertigo. The length of time that this surgery remains effective varies between patients.
As with any surgery, there are possible complications, and if this surgery is recommended to you, an informed consent listing those possible complications will be provided to you.
There are several other surgical procedures that are performed less commonly, including vestibular nerve section and labyrinthectomy.