Medical management of Ménière's disease.

OBJECTIVES: Ménière's disease (MD) is poorly understood with respect to its etiology, pathophysiology, clinical course, and treatment. Furthermore, in the absence of controlled clinical studies, empiric treatments have been used with varying degrees of success. In this paper, the authors review the current medical management of MD.

STUDY DESIGN: Literature review.

RESULTS: Because of a dearth of well-controlled studies, the medical management of MD remains empirical and is largely restricted to lifestyle changes, pharmacotherapy, and office-based procedures. The development of transtympanic therapies represents a true therapeutic advance that has largely supplanted surgical intervention. A treatment algorithm for acute and chronic medical management is reviewed.

CONCLUSIONS: Despite absence of a complete understanding of MD, medical management or its natural history leads to control of vertigo in the majority of patients. Basic research is needed to understand its pathophysiology so that directed therapies can be developed and can be tested in well-controlled clinical trials.