While a 2005 review found tentative evidence of benefit from tympanostomy tubes for improvement in the unsteadiness associated with the disease, a 2014 review concluded that their use is not supported.Destructive surgeries are irreversible and involve removing entire functionality of most, if not all, of the affected ear; as of 2013, almost no evidence existed with which to judge whether these surgeries are effective. The inner ear itself can be surgically removed via labyrinthectomy, although hearing is always completely lost in the affected ear with this operation. The surgeon can also cut the nerve to the balance portion of the inner ear in a vestibular neurectomy. The hearing is often mostly preserved; however, the surgery involves cutting open into the lining of the brain, and a hospital stay of a few days for monitoring is required. Poorly supported
As of 2014, betahistine is often used as it is inexpensive and safe; but evidence does not justify its use in MD. Transtympanic micropressure pulses were investigated in two systematic reviews. Neither found evidence to justify this technique. Intratympanic steroids were investigated in three systematic reviews. The data were found to be insufficient to decide if this therapy has positive effects. Evidence does not support the use of alternative medicine such as acupuncture or herbal supplements. Prognosis
Ménières disease usually starts confined to one ear; it extends to both ears in about 30% of cases. People may start out with only one symptom, but in MD all three appear with time.
Hearing loss usually fluctuates in the beginning stages and becomes more permanent in later stages. MD has a course of 5–15 years, and people generally end up with mild disequilibrium, tinnitus, and moderate hearing loss in one ear. Epidemiology
From 3 to 11% of diagnosed dizziness in neuro-otological clinics are due to MD. The annual incidence rate is estimated to be about 15 cases per 100,000 people and the prevalence rate is about 218 per 100,000, and around 15% of people with Menieres disease are older than 65. In around 9% of cases, a relative also had MD, indicating a genetic predisposition in some cases.The odds of MD are greater for people of white ethnicity, with severe obesity, and women. Several conditions are often comorbid with MD, including arthritis, psoriasis, gastroesophageal reflux disease, irritable bowel syndrome, and migraine. History
The condition is named after the French physician Prosper Menière, who in an 1861 article described the main symptoms and was the first to suggest a single disorder for all of the symptoms, in the combined organ of balance and hearing in the inner ear.The American Academy of Otolaryngology–Head and Neck Surgery Committee on Hearing and Equilibrium set criteria for diagnosing MD, as well as defining two subcategories – cochlear (without vertigo) and vestibular (without deafness).In 1972, the academy defined criteria for diagnosing MD as:
Fluctuating, progressive, sensorineural deafness
Episodic, characteristic definitive spells of vertigo lasting 20 minutes to 24 hours with no unconsciousness, vestibular nystagmus always present.