Treatment of Meniere’s Syndrome or Disease
Syed et al (2015) evaluated the evidence-based treatments of Meniere’s Syndrome and/or Meniere’s Disease (MS/D) over the last two decades. One hundred and four (104) studies from the first decade (1994-2003) and 101 from the second decade (2004-2013) were included. They report a statistical decline in surgeries (from 43 percent to 27 percent, from the first decade to the second, respectively) and an increase in intratympanic steroid injections and an increase in use of the Meniett device. The authors report a significant shift in studies with Level I evidence (the highest level) from the first decade to the second, from 5 percent to 18 percent, respectively.
Of note, typical MS/D treatments involve low-salt diets. However, investigators have “challenged the simple notion that salt restriction affects the fluid dynamics of the ear in ways that would significantly influence the degree of hydrops….” Syed et al report only one study (Luxford et al, 2013) indicated salt reduction was helpful to the patients (with regard to MS/D) and that particular study offered only Level Three (individual case control study) evidence partly based on caffeine-free and low-salt diets. Luxford and colleagues concluded that “nutrition education by referral to a registered dietician may improve outcomes....” Syed et al report on a Cochrane Review (2006) and noted that “there is no good evidence for or against the use of diuretics in the treatment of MS/D….” A separate Cochrane Review (2013) reported no benefit from endolymphatic surgery with regard to the treatment of MS/D.
For More Information, References, and Recommendations
Luxford E, Berliner KI, Lee J, Luxford WM. (2015) Dietary Modification as Adjunct Treatment in Meniere’s Disease: Patient Willingness and Ability to Comply. Otol Neurotol 34:1438-1443.
Pullens B, Verschur HP, van Benthem PP. (2013) Surgery for Meniere’s Disease. Cochrane 2013: Cochrane Database Syst Rev 2013. 2:cd005395.
Syed MI, Ilan O, Leong AC, Pothier DD, Rurka JA. (2015) Meniere’s Syndrome or Disease—Time Trends in Management and Quality of Evidence Over the Last Two Decades. Otol Neurotol 36:1309-1316.
Thirlwall AS, Kundu S. (2006) Diuretics for Meniere’s Disease or Syndrome. Cochrane 2006: Cochrane Database Syst Rev.CD003599.