Therapy

The treatment of Menière’s disease is still strongly discussed from today’s point of view. The reason for this is that the exact cause which led to the development of the disease is largely unknown. However, the pathomechanism, i.e. the active form of the disease, is understood and can be treated, so that the patients’ suffering is alleviated.

In some cases, Menière’s disease can even be treated so well that seizures do not occur at all. In this case, an improvement of the symptoms can also be achieved through surgical procedures. For example, a tympanic tube can be inserted through the eardrum, which acts as a link between the external auditory canal and the middle ear.

As a result, the pressure fluctuations of the middle ear, which are particularly strong in Meniere’s disease, are no longer as pronounced. The pressure fluctuations of the middle ear are in fact related in a complicated way to the pressure conditions in the inner ear, which in turn can influence the attacks of Meniere’s disease. Alternatively, a change in lifestyle can bring about an improvement.

Relaxation and balance exercises in particular, but also psychotherapy, can often help those affected. In addition, the diet should be taken into account. It is advisable to eat a lot of potassium and little salt.

Stress, alcohol, smoking and loud noise levels should also be avoided as far as possible. In acute cases of Meniere’s disease, treatment is limited to the symptoms. Dizziness and vomiting in particular can be treated with medication.

Antiemetics (drugs against vomiting) such as dimenhydrinate (Vomex®) or metoclopramide (MCP drops) can be used for this purpose.Endolymphatic hydrops, the direct cause of Meniere’s symptoms, is treated with betahistine. Betahistine is effective against nausea, vomiting and dizziness by promoting blood flow to the inner ear and improving the regulation of balance. However, it is controversial whether the drug is really effective, as various studies doubt the effectiveness of betahistine.

Potassium-sparing diuretics are used as alternative drugs. Diuretics are drugs that inhibit certain transporters in the kidney so that more water is excreted. Taking diuretics in Meniere’s disease is intended to flush out the accumulation of fluid in the inner ear, which in turn improves the symptoms