Meniere's Disease

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Duke otologists and neurotologists diagnose and treat Meniere’s disease, a chronic condition of the inner ear that can cause vertigo (dizziness), hearing loss, and tinnitus. Usually only present in one ear, Meniere’s disease (or syndrome) is an excess of normal fluid in the inner ear. While there is no cure, treatment can reduce symptoms and minimize its impact on your quality of life.

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Tests

Audiogram

Audiologists, who specialize in hearing loss, use different types of tests to learn whether you have hearing loss and, if so, whether it’s caused by problems in the inner ear.

Balance Testing

Duke uses sophisticated technology to help doctors understand the cause and extent of your dizziness.

Video/Electronystagmography (VNG/ENG): Small amounts of warm or cool water are poured into your ear canals. Then an audiologist will ask you questions and measure your eye movements.
Rotational chair: Assesses the interaction between your eyes and inner ears. In a dark room, you’ll watch patterns of light. At times, your chair will rotate and you’ll be asked to look straight ahead and talk with the test administrator.
Vestibular Evoked Myogenic Potential (VEMP): Allows doctors to see how well your ears’ vestibular (balance) nerves are working. You’ll lie back in a chair and listen to sounds through headphones while an audiologists tracks how your neck muscles and eyes react.
Video Head Impulse Test (vHIT): You will be asked to wear a head device while an audiologist moves your head and measures how your eyes move in response.

CT and MRI Scans

CT imaging allows ENT doctors to get a detailed look at important bones in and around your ear, while MRI images show the intricacies of softer tissues like nerves, inner ear fluids, and the brain.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Treatments

Lifestyle Changes

A diet low in sodium, caffeine, and alcohol may help reduce your Meniere’s symptoms. Quitting smoking may also help.

Vestibular Therapy

Balance exercises can help your brain compensate for your damaged balance mechanism. This special form of physical therapy trains your body to make up for inner ear dysfunction, helps you feel steadier on your feet, and reduces the risk of falling.

Medications

Your doctor may prescribe medications to address immediate symptoms or prevent future episodes. These may include diuretics (which reduce fluid retention), motion sickness drugs, and anti-nausea medications.

Hearing Devices

Implantable hearing devices, such as cochlear implants or bone conduction hearing aids, can help restore hearing.

Inner Ear Perfusions

Direct delivery of medications to the inner ear may help reduce symptoms associated with Meniere’s disease. It could take months before you notice results. The doctor will numb your eardrum before injecting the medication, so pain is minimal. Typically, a series of steroid (dexamethasone) injections is the first option. If that fails, ENT specialists may opt for a series of antibiotic (gentamicin) injections. The goal of this medication is to purposefully disable balance nerves that cause vertigo.

Surgical Treatments

The following are more complex surgeries for Meniere’s disease that require general anesthesia.

Labyrinthectomy

Typically reserved for people who already have severe or total hearing loss in the affected ear, this surgery removes the labyrinth (the inner ear balance organ), eliminating the source of dizziness. You’ll likely be able to go home the same day as your surgery, although you may experience dizziness for a few days as your remaining labyrinth compensates to restore balance. Ironically, this takes less time in people who had severe balance loss before surgery.

Endolymphatic Sac Decompression

This procedure removes the bone located over the endolymphatic sac (a pouch that helps drain fluid from the inner ear), allowing it to function better. Sometimes an opening is made in the sac and a shunt or tube is placed to aid drainage. Altogether, the procedure lasts about an hour and patients typically go home the same day.

Vestibular Neurectomy

Preferred when a person has not had much hearing loss, this procedure requires surgically opening the skull (a craniotomy). Once inside, a surgeon cuts the balance nerve near where it exits the brain, which interrupts the signals that make you feel dizzy. The surgery lasts about two hours. Patients usually spend a few days in the hospital afterward to recover.

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Why Choose Duke

Advanced Technology
From testing to surgical techniques, our experts use specialized tools to increase accuracy, boost efficiency, and reduce risk.

Complex Care
Otologists/neurotologists are ENT specialists who complete an additional two years of training to specialize in treating complicated ear disorders and performing intricate ear surgeries. Working together with other specialists as needed -- including otolaryngologists, audiologists, vestibular specialists, neurologists, neurosurgeons, and others -- Duke’s ear experts provide high-quality ear care.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 01/05/2024 by

David M. Kaylie, MD, MS | Ear, Nose and Throat Doctor