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Meniere's disease

A Ménière's disease diagnosis can take years to arrive — and when it does, it often comes with more questions than answers. What causes it? How is it confirmed? And what can actually be done about it? In this course, we answer all three. You'll learn to recognize the hallmark pattern of Ménière's disease, understand what the available diagnostic tests can and cannot tell you, and explore the full range of management options — from dietary changes and medication to surgical interventions — so you can have an informed conversation with your care team about what's right for you.

This material is intended for educational purposes only, and does not substitute evaluation by a qualified medical professional.

In developing this course we reviewed literature (so that you don't have to)!

 

These were the original articles by Dr. Prospere Ménière:

  • Ménière, Prosper (1861). Maladies de l’oreille interne offrant des symptoms de la congestion cerebral apoplectiforme.  Gaz Med de Paris, 16:88.
  • Ménière, Prosper (1861). Sur une forme de surdité grave dépendant d’une lésion de l’oreille interne. Bulletin de l’Adadémie Impériale de médecine, 26, 241.

 

Literature that may be useful to patients:

  • Acharya A, Singh M, Shrestha A (2016) First Line Treatment of Meniere’s Disease. Journal of Lumbini Medical College 4: 68. doi: 10.22502/jlmc.v4i2.93
  • De Luca P, Cassandro C, Ralli M, Gioacchini FM, Turchetta R, Orlando MP, Iaccarino I, Cavaliere M, Cassandro E, Scarpa A (2020) Dietary Restriction for The Treatment of Meniere's Disease. Transl Med UniSa 22: 5-9. 
  • Derebery MJ, Berliner KI (2010) Allergy and its relation to Meniere's disease. Otolaryngol Clin North Am 43: 1047-58. doi: 10.1016/j.otc.2010.05.004
  • Gao W, Ma P, Wang Z, Guo J, Lun Y, Wang W, Yuan H, Li S, Liang R, Lu L (2024) Restriction of salt, alcohol and coffee intake and Ménière's disease: insight from Mendelian randomization study. Front Nutr 11: 1460864. doi: 10.3389/fnut.2024.1460864
  • Havia M, Kentala E (2004) Progression of symptoms of dizziness in Meniere's disease. Arch Otolaryngol Head Neck Surg 130: 431-5. doi: 10.1001/archotol.130.4.431
  • Hussain K, Murdin L, Schilder AG (2018) Restriction of salt, caffeine and alcohol intake for the treatment of Ménière's disease or syndrome. Cochrane Database Syst Rev 12: Cd012173. doi: 10.1002/14651858.CD012173.pub2
  • James, A. L., Burton, M. J. (2001). Betahistine for Meniere's disease or syndrome. Cochrane Database Syst Rev(1), CD001873.
  • Lassen, L. F., Hirsch, B. E., Kamerer, D. B. (1996). Use of nimodipine in the medical treatment of Meniere's disease: clinical experience. Am J Otol, 17(4), 577-580.
  • Lee A, Webster KE, George B, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Ray J, Van Vugt VA, Burton MJ (2023) Surgical interventions for Meniere's disease. Cochrane Database Syst Rev 2: CD015249. doi: 10.1002/14651858.CD015249.pub2
  • Monsell EM, Balkany TA, Gates GA, Goldenberg RA, Meyerhoff WL, House JW (1995) Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg 113: 181-5. doi: 10.1016/S0194-5998(95)70102-8
  • Pullens B, van Benthem PP (2011) Intratympanic gentamicin for Meniere's disease or syndrome. Cochrane Database Syst Rev: CD008234. doi: 10.1002/14651858.CD008234.pub2
  • Pullens B, Verschuur HP, van Benthem PP (2013) Surgery for Meniere's disease. Cochrane Database Syst Rev 2013: CD005395. doi: 10.1002/14651858.CD005395.pub3
  • Sánchez-Sellero I, San-Román-Rodríguez E, Santos-Pérez S, Rossi-Izquierdo M, Soto-Varela A (2018) Caffeine intake and Menière's disease: Is there relationship? Nutr Neurosci 21: 624-631. doi: 10.1080/1028415x.2017.1327636
  • Santos PM, Hall RA, Snyder JM, Hughes LF, Dobie RA (1993) Diuretic and diet effect on Meniere's disease evaluated by the 1985 Committee on Hearing and Equilibrium guidelines. Otolaryngol Head Neck Surg 109: 680-9. doi: 10.1177/019459989310900408
  • Stahle J, Friberg U, Svedberg A (1991) Long-term progression of Meniere's disease. Acta Otolaryngol Suppl 485: 78-83. doi: 10.3109/00016489109128047
  • Thirlwall, A. S., Kundu, S. (2006). Diuretics for Meniere's disease or syndrome. Cochrane Database Syst Rev(3), 
  • van Deelen, G. W., Huizing, E. H. (1986). Use of a diuretic (Dyazide) in the treatment of Meniere's disease. A double-blind cross-over placebo-controlled study. ORL J Otorhinolaryngol Relat Spec, 48(5), 287-292.
  • Webster KE, Lee A, Galbraith K, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Ray J, Van Vugt VA, Westerberg B, Burton MJ (2023) Intratympanic corticosteroids for Meniere's disease. Cochrane Database Syst Rev 2: CD015245. doi: 10.1002/14651858.CD015245.pub2
  • Weinreich HM, Agrawal Y (2014) The link between allergy and Meniere's disease. Curr Opin Otolaryngol Head Neck Surg 22: 227-30. doi: 10.1097/MOO.0000000000000041
  • Wladislavosky-Waserman P, Facer GW, Mokri B, Kurland LT (1984) Meniere's disease: a 30-year epidemiologic and clinical study in Rochester, Mn, 1951-1980. Laryngoscope 94: 1098-102. doi: 10.1288/00005537-198408000-00020
  • Wu Y, Zhou Y, Yu J, Song Z, Dai C, Wang J (2021) Intratympanic gentamicin injection for refractory ménière's disease (MD) has potential effect in preventing contralateral MD occurrence. Acta Oto-Laryngologica: 1-6. doi: 10.1080/00016489.2021.1915499

 

Literature for specialists who want to dig deeper:

  • Adams ME, Heidenreich KD, Kileny PR (2010) Audiovestibular Testing in Patients with Meniere's Disease. Otolaryngologic Clinics of North America 43: 995-1009. doi: https://doi.org/10.1016/j.otc.2010.05.008
  • Banks C, McGinness S, Harvey R, Sacks R (2012) Is allergy related to Meniere's disease? Curr Allergy Asthma Rep 12: 255-60. doi: 10.1007/s11882-012-0258-3
  • Bertlich, M., Ihler, F., Sharaf, K., Weiss, B. G., Strupp, M., Canis, M. (2014). Betahistine metabolites, Aminoethylpyridine, and Hydroxyethylpyridine increase cochlear blood flow in guinea pigs in vivo. Int J Audiol, 53(10), 753-759.
  • Casani AP, Piaggi P, Cerchiai N, Seccia V, Franceschini SS, Dallan I (2012) Intratympanic treatment of intractable unilateral Meniere disease: gentamicin or dexamethasone? A randomized controlled trial. Otolaryngol Head Neck Surg 146: 430-7. doi: 10.1177/0194599811429432
  • Djelilovic-Vranic, J., Alajbegovic, A., Tiric-Campara, M., Volic, A., Sarajlic, Z., Osmanagic, E., . . . Beslagic, O. (2012). Betahistine or Cinnarizine for treatment of Meniere's disease. Med Arch, 66(6), 396-398.
  • Driscoll CL, Kasperbauer JL, Facer GW, Harner SG, Beatty CW (1997) Low-dose intratympanic gentamicin and the treatment of Meniere's disease: preliminary results. Laryngoscope 107: 83-9. doi: 10.1097/00005537-199701000-00017
  • Eppsteiner RW, Smith RJ (2011) Genetic disorders of the vestibular system. Curr Opin Otolaryngol Head Neck Surg 19: 397-402. doi: 10.1097/MOO.0b013e32834a9852
  • Fraysse, B., Bebear, J. P., Dubreuil, C., Berges, C., Dauman, R. (1991). Betahistine dihydrochloride versus flunarizine. A double-blind study on recurrent vertigo with or without cochlear syndrome typical of Meniere's disease. Acta Otolaryngol Suppl, 490, 1-10.
  • Fukushima M, Oya R, Nozaki K, Eguchi H, Akahani S, Inohara H, Takeda N (2018) Vertical head impulse and caloric are complementary but react opposite to Meniere's disease hydrops. Laryngoscope. doi: 10.1002/lary.27580
  • Garduno-Anaya MA, Couthino De Toledo H, Hinojosa-Gonzalez R, Pane-Pianese C, Rios-Castaneda LC (2005) Dexamethasone inner ear perfusion by intratympanic injection in unilateral Meniere's disease: a two-year prospective, placebo-controlled, double-blind, randomized trial. Otolaryngol Head Neck Surg 133: 285-94. doi: 10.1016/j.otohns.2005.05.010
  • Gartner M, Bossart W, Linder T (2008) Herpes virus and Meniere's disease. ORL J Otorhinolaryngol Relat Spec 70: 28-31; discussion 31. doi: 10.1159/000111045
  • Greco A, Gallo A, Fusconi M, Marinelli C, Macri GF, de Vincentiis M (2012) Meniere's disease might be an autoimmune condition? Autoimmun Rev 11: 731-8. doi: 10.1016/j.autrev.2012.01.004
  • Havia M, Kentala E, Pyykko I (2005) Prevalence of Meniere's disease in general population of Southern Finland. Otolaryngol Head Neck Surg 133: 762-8. doi: 10.1016/j.otohns.2005.06.015
  • Hwang JH, Ho HC, Hsu CJ, Yang WS, Liu TC (2008) Diagnostic Value of Combining Bilateral Electrocochleography Results for Unilateral Ménière’s Disease. Audiology and Neurotology 13: 365-369. doi: 10.1159/000136155
  • Kharkheli E, Japaridze S, Kevanishvili Z, Oz I, Ozluoglu LN (2019) Correlation between Vestibular Evoked Myogenic Potentials and Disease Progression in Meniere's Disease. ORL J Otorhinolaryngol Relat Spec: 1-9. doi: 10.1159/000496088
  • Lopez-Escamez JA, Carey J, Chung WH, Goebel JA, Magnusson M, Mandala M, Newman-Toker DE, Strupp M, Suzuki M, Trabalzini F, Bisdorff A, Classification Committee of the Barany S, Japan Society for Equilibrium R, European Academy of O, Neurotology, Equilibrium Committee of the American Academy of O-H, Neck S, Korean Balance S (2015) Diagnostic criteria for Meniere's disease. J Vestib Res 25: 1-7. doi: 10.3233/VES-150549
  • Mavrodiev V, Strupp M, Vinck A-S, van de Berg R, Lehner L (2024) The dissociation between pathological caloric testing and a normal video head impulse test helps differentiate between Menière’s disease, vestibular migraine, and other vestibular disorders: a confirmatory study in a large cohort of 2,101 patients. Frontiers in Neurology 15.
  • Michaels L, Soucek S, Linthicum F (2009) The intravestibular source of the vestibular aqueduct: Its structure and pathology in Meniere's disease. Acta Otolaryngol 129: 592-601. doi: 10.1080/00016480802342416
  • Rauch SD, Merchant SN, Thedinger BA (1989) Meniere's syndrome and endolymphatic hydrops. Double-blind temporal bone study. Ann Otol Rhinol Laryngol 98: 873-83. doi: 10.1177/000348948909801108
  • Telischi J, Strepay D, Li B, Chisholm J, Cheng H, Brewer C, Hsu L-Y, Butman J, Hoa M (2025) MRI-based measurement of inner ear fluids reveals increased endolymph volume variability in patients with endolymphatic hydrops and hearing instability. Scientific Reports 15: 22560. doi: 10.1038/s41598-025-06083-w
  • Trinidade A, Robinson T, Phillips JS (2014) The role of caffeine in otorhinolaryngology: guilty as charged? Eur Arch Otorhinolaryngol 271: 2097-102.
  • Tumarkin A (1936) The Otolithic Catastrophe: A New Syndrome. Br Med J 2: 175-7. doi: 10.1136/bmj.2.3942.175