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o t ol a r y n g o lo g y
Relief from Severe Symptoms of
May Include Lifestyle, Surgical Options
Ménière’s disease is a disorder of the inner ear that affects balance and hearing.
An estimated 615,000 people in the United States have the condition,
and more than 45,000 new cases are diagnosed each year.
A lthough the signs of Ménière’s disease
rarely occur until people reach
their 40s or 50s, the disorder may
eventually result in debilitating symptoms that
literally throw patients off balance.
“Ménière’s patients may suddenly feel like the
room is spinning around rapidly, sometimes
for hours at a time,” says neurotologist-
otolaryngologist Akira Ishiyama, MD,
UCLA head and neck surgeon. Such episodes
of extreme dizziness (vertigo) are often
associated with nausea and vomiting. “The
symptoms can be so devastating that patients
can no longer drive or work or participate in
other normal activities,” Dr. Ishiyama adds.
Ringing in the ear (tinnitus), feeling of fullness
or pressure in the ear, fluctuating hearing loss
and pain similar to migraine headaches are
also associated with Ménière’s disease. The
timing of Ménière’s episodes is unpredictable.
Extreme symptoms can cause patients to lose
their balance and fall. These episodes, known
as “drop attacks,” may result in serious injury.
“Patients say it feels like a giant hand comes
from the sky and smashes them to the
ground,” says Dr. Ishiyama.
UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631)
The exact cause of the disease is unknown
and no cure exists. Symptoms of Ménière’s
disease result from the buildup of fluid in
the compartments of the inner ear called
the labyrinth. Diagnosis usually includes
documentation of symptoms, a physical
examination, hearing tests to establish the
extent of hearing loss and imaging tests to
rule out other diseases. At UCLA, a team of
specialists including otolaryngologists (ear,
nose and throat surgeons), neurologists and
neurosurgeons work together to diagnose the
disease and related disorders and to develop
the most appropriate treatment plan.
According to Dr. Ishiyama, relief for some
patients may be as simple as restricting salt
intake and taking diuretics (water pills) to
control water retention. Used in combination,
this regimen is the most common long-term
treatment for Ménière’s disease. If this first-
line treatment fails, however, medication to
regulate inner ear fluid pressure, injections of
antibiotics or corticosteroids into the middle
ear to control vertigo, or surgical interventions
may be required.
“Some patients can no longer tolerate their
symptoms and choose more aggressive
therapies to improve their quality of life,”
explains Dr. Ishiyama. Because Ménière’s
disease may cause permanent hearing
loss, treatment varies on hearing function.
For patients with good hearing, a surgical
treatment to clip the vestibular nerve may be
recommended, while surgical removal of a
portion of the inner ear may be indicated for
patients with poor hearing function. Both
operations address vertigo. These procedures
relieve symptoms in more than 95 percent
of appropriate patients, according to Dr.
Ishiyama. He cautions that a comprehensive
evaluation to understand the nature and
extent of the disease should always precede
To watch a video about
treatment for Ménière’s
disease, go to: