Medical management of Ménière's disease: a 10-year case series and review of literature.

Ménière's disease is frequent in our area. It is a disabling pathology that affects the patient's quality of life. Its etiology and pathophysiology remain unclear and there are some therapeutic alternatives with controversial results. We present our series and treatment protocol for Ménière's disease and discuss the current evidence regarding its medical treatment. In the last 10 years, 252 patients were diagnosed with Ménière's disease based on their symptoms, and the results of tonal audiometry, videonystagmography and caloric stimulation tests. All cases received medical treatment according to our management protocol. Ménière's disease is more frequent in women (54.76%); 83.73% of cases are unilateral. Among these, vertigo was observed in 93.7%, hearing loss in 88.1%, tinnitus in 86.1% and pathologic caloric stimulation tests in 71% (88.27% with a reduced vestibular response). A 5-year follow-up was performed in 89.6% of the patients. Subjective improvement as reported by patients was achieved in 94.4% of the cases. There is great controversy about the medical treatment of Ménière's disease. We found no evidence for the most adequate medical treatment among the different alternatives described in literature. The patient's acceptance and understanding of the disease is very important.