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Author: admin, 10.11.2013. Category: Treatment For Tinnitus

Episodic vertigo is the most common reason for patients to seek and pursue treatment for Meniere’s disease. If episodes of vertigo persist despite changes in diet, medication called diuretics can be helpful.
Other options are available and include transtympanic decadron or gentamicin, decadron perfusion of the inner ear, endolymphatic sac surgery, vestibular neurectomy and labyrinthectomy surgery.
Steroid treatment of the inner ear may offer beneficial effects for the symptoms of Meniere’s disease. A powerful way of delivering steroid to the inner ear is by injection into the middle ear through the tympanic membrane. There is a 1% chance of a persistent 1 mm perforation of the eardrum at the injection site. This form of treatment involves injection of medication through the eardrum into the middle ear. A shunt is placed in the endolymphatic sac, a reservoir for endolymph, to shuttle fluid out of the sac and into a cavity created in the mastoid. Step 3: A mastoidectomy is done exposing the semicircular canals, venous sinus, and dura covering the brain. Step 4: Spinal fluid is drained and the brain relaxes, exposing the trigeminal nerve (responsible for the conduction of facial sensation), the vestibulocohlear nerve (hearing and balance), and the facial nerve. This is an operation to divide the balance nerves and interrupt the connection between the inner ear and the brain. The middle fossa approach is the least commonly used and involves an incision above the ear followed by removal of bone over the brain. Another approach is the retrolabyrinthine approach, which involves incisions behind the ear similar to the endolymphatic shunt procedure. A third approach is the suboccipital approach, which involves an incision further behind the ear and removal of bone over the covering of the brain.


Learn how Metropolitan NeuroEar Group gives back to the community through numerous philanthropic efforts. Reducing or eliminating smoking is not only good for Meniere’s disease but also good for your health in general.
Administration of steroids to the inner ear is an attempt to reduce the inflammation within the inner ear. From here, the steroid diffuses through the round window (one of the two openings into the cochlea of the inner ear)membrane and enters the inner ear. The medication, which is then taken up by the inner ear, destroys the hair cells of the inner ear. Of the surgical options, this is the most conservative operation with minimal risk to hearing. The mastoid bone is entered and the endolymphatic sac is decompressed, meaning that the bony covering is removed. The ear may protrude slightly shortly after surgery, but it should return to its original position in two to three weeks.
90-95 percent of patients who undergo this operation for Meniere’s disease will not have another spell of vertigo. The roof of the canal through which the balance nerves run is removed and the nerves are then divided. Nearly all patients with Meniere's disease will be vertigo-free after a labyrinthectomy.
Using a high-powered drill, the mastoid bone is entered and the semicircular canals are removed.
Sanjay Prasad MD FACS is a board certified physician and surgeon with over twenty years of sub-specialty experience in Otology, Neurotology, advanced head and neck oncologic surgery, and cranial base surgery.
Close monitoring of blood pressure and potassium levels by your primary care physician is recommended.


During the procedure, the eardrum is elevated and the round window (one of the two openings into the cochlea of the inner ear) membrane is perfused with high-dose steroid. The medication, Gentamicin, is an antibiotic that is toxic to the hair cells of the hearing and balance organ. Unfortunately, control of vertigo occurs in only 60 percent of patients undergoing this operation. After the operation, disequilibrium lasts until the brain learns to compensate and adapt to the lack of input from one inner ear. He is chief surgeon and founder of the private practice, Metropolitan NeuroEar Group, located in the metropolitan Washington D.C. This is a relatively painless procedure that involves anesthetizing the tympanic membrane and then injecting the steroid thereafter. The fluid that would normally enter the sac is shunted away from the inner ear and into the cavity created by the surgery, where it is then reabsorbed.
This is an operation that is recommended to patients who have no useful hearing in the dysfunctional ear. Avoiding adding salt to meals and curtailing intake of snacks high in sodium, including canned foods and fried foods, can be helpful. Just as in vestibular neurectomy, after the operation, disequilibrium lasts until the brain learns to compensate and adapt to the lack of input from one inner ear. These electrodes detect contractions of the facial muscles, and the signals are transmitted to a speaker so the surgeon may hear the responses.



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