Management of Meniere's disease. Surgery may help if medication fails.

Meniere's disease is the classic triad of fluctuating hearing loss, episodic vertigo, and severe tinnitus. It usually occurs unilaterally, although about 15% to 20% of patients may have bilateral disease. The disease involves a series of acute exacerbations followed by a period of remission; it progresses until the ear has essentially "burned itself out," causing symptoms to subside. Treatment of Meniere's disease should be tailored to the severity of symptoms and the patient's life-style. Initial treatment involves conservative medical management and psychologic support. If this fails, endolymphatic shunt surgery is effective in alleviating symptom in the majority of patients.