Medical management of Ménière’s disease: a 10-year case series and review of literature
OBJECTIVE Ménière's disease in an only hearing ear is rare. Our objective is to define the current practice patterns for this problem. SUBJECTS Clinically active members of the American Otological Society and the American Neurotology Society. MAIN OUTCOME MEASURE Survey responses. RESULTS Three hundred fifty-four surveys were sent out, and 165 were returned (48%). Ninety-nine percent recommended dietary modification as first line. Only 39% recommended oral corticosteroids. Second-line treatments were, in order of significance, the Meniett device (Medtronic ENT, Jacksonville, FL, USA), intratympanic corticosteroids, endolymphatic mastoid shunt, intratympanic gentamicin, and endolymphatic sac vein decompression. Interestingly, 71.5% of respondents would operate on an only hearing ear provided the appropriate circumstances. CONCLUSION We have documented current practice patterns for treatment. Second-line treatments vary, but the Meniett is recommended most frequently, and further recommendations may not logically progress from least to most invasive. Many respondents eventually offer surgery.