Surgery and Time Help Ménière's Patients

(November 18, 2008) - The passage of time and surgery can both be helpful to people who suffer dizziness from Ménière's disease. (Read about "Balance Disorders") That's according to a pair of studies in the Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.

Episodes of dizziness tend to become less frequent over time in patients with Ménière's disease, a condition characterized by vertigo, hearing loss and ringing in the ears. (Read about "Tinnitus") In addition, a surgical procedure to drain fluid from the inner ear (Read about "The Ear & Hearing") appears to reduce vertigo in three-fourths of patients with the condition.

In the first study, researchers followed 510 individuals who met criteria for definitive Ménière's disease.

"Ménière's disease affects both sexes and both ears equally, with onset generally in the fourth decade of life," the authors write. "The number of episodes of vertigo is greater in the first few years of the disease. Although episodes of vertigo that last longer than six hours are less frequent than shorter episodes, they occur with similar frequency throughout the natural course of the disease."

The percentage of patients with no episodes of vertigo increases as the disease progresses, and 70 percent of patients who did not have vertigo during any one year also did not have any episodes in the following year. "In contrast, the likelihood that patients who had episodes of vertigo continued to have them was slightly greater than 50 percent," the authors write.

In the second study, 51 patients (who did not respond to more conservative therapies - such as low-sodium diets or diuretic medications) underwent endolymphatic sac surgery. An additional 16 underwent revision surgery for recurring disease. The surgery involves inserting a shunt into the endolymphatic sac in the inner ear and draining the fluid inside to relieve symptoms.

After 24 months, the surgery improved major spells of vertigo in 77 percent of patients undergoing the procedure for the first time and 65 percent of patients undergoing revision surgery. For those having revision surgery, results appeared better in patients who developed recurrent symptoms more than two years after than procedure than among those who failed treatment earlier.