Menière's disease.

Menière's disease is one of the most common etiologies for dizziness in the United States. The mainstay of therapy for Menière's is medical therapy. Symptomatic treatment is employed, but long-term prophylaxis is emphasized, with salt restriction and diuretic administration as needed. A prophylactic approach can prevent many attacks and ameliorate those that do occur. Patients with moderate to severe symptoms who fail medical therapy may be candidates for endolymphatic sac surgery, since this procedure is successful in a majority of patients and has low morbidity. Those patients in whom an endolymphatic shunt fails and who continue to have severe symptoms may undergo selective sectioning of the vestibular nerve, while patients with no residual hearing may be offered translabyrinthine nerve section.