No cure for<unk>  is known, but medications, diet, physical therapy, and counseling, and some surgical approaches can be used to manage it. Medications During MD episodes, medications to reduce nausea are used, as are drugs to reduce the anxiety caused by vertigo. For longer-term treatment to stop progression, the evidence base is weak for all treatments. Although a causal relation between allergy and<unk>  is uncertain, medication to control allergies may be helpful. To assist with vertigo and balance problems, glycopyrrolate has been found to be a useful vestibular suppressant in patients with Meniere's<unk> . Diuretics, such as the thiazide-like diuretic chlortalidone, are widely used to manage MD on the theory that it reduces fluid buildup (pressure) in the ear. Based on evidence from multiple but small clinical trials, diuretics appear to be useful for reducing the frequency of episodes of dizziness but do not seem to prevent hearing loss. In cases where hearing loss and continuing severe episodes of vertigo occur, a chemical labyrinthectomy, in which a medication such as gentamicin is injected into the middle ear and kills parts of the vestibular apparatus, may be prescribed. This treatment has the risk of worsening hearing loss. Diet People with MD are often advised to reduce their sodium intake. Reducing salt intake, however, has not been well studied.Based on the assumption that MD is similar in nature to a migraine, some advise eliminating "migraine triggers" such as caffeine, but the evidence for this is weak. There is no high-quality evidence that changing diet by restricting salt, caffeine or alcohol improves symptoms. Physical therapy While use of physical therapy early after the onset of MD is probably not useful due to the fluctuating<unk>  course, physical therapy to help retraining of the balance system appears to be useful to reduce both subjective and objective deficits in balance over the longer term. Counseling The psychological distress caused by the vertigo and hearing loss may worsen the condition in some people. Counseling may be useful to manage the distress, as may education and relaxation techniques. Surgery If symptoms do not improve with typical treatment, surgery may be considered. Surgery to decompress the endolymphatic sac is one option. A systematic review in 2015 found that three methods of decompression have been used - simple decompression, insertion of a shunt, and removal of the sac. It found some evidence that all three methods were useful for reducing dizziness, but that the level of evidence was low, as trials were not blinded nor were placebo controls used. Another 2015 review found that, on autopsy, shunts used in these surgeries often turn out to be displaced or misplaced, and recommended their use only in cases where the condition is uncontrolled and affecting both ears. A systematic review from 2014 found that in at least 75% of people, EL sac decompression was effective at controlling vertigo in the short term (>1 year of follow-up) and long term (>24 months). An estimated 30% of people with MD have Eustachian tube dysfunction. While a 2005 review found tentative evidence of benefit from tympanostomy tubes for improvement in the unsteadiness associated with the<unk> , a 2014 review concluded that their use is not supported. Destructive surgeries are irreversible and involve removing entire functionality of most, if not all, of the affected ear; as of 2013, almost no evidence existed with which to judge whether these surgeries are effective. The inner ear itself can be surgically removed via labyrinthectomy, although hearing is always completely lost in the affected ear with this operation. The surgeon can also cut the nerve to the balance portion of the inner ear in a vestibular neurectomy. The hearing is often mostly preserved; however, the surgery involves cutting open into the lining of the brain, and a hospital stay of a few days for monitoring is required. Poorly supported * As of 2014, betahistine is often used as it is inexpensive and safe; but evidence does not justify its use in MD. * Transtympanic micropressure pulses were investigated in two systematic reviews. Neither found evidence to justify this technique. * Intratympanic steroids were investigated in three systematic reviews. The data were found to be insufficient to decide if this therapy has positive effects. * Evidence does not support the use of alternative medicine such as acupuncture or herbal supplements.
Ménière's disease
Benign paroxysmal positional vertigo
Eagle syndrome
Red ear syndrome
Wellens' syndrome
Musical ear syndrome
Empty sella syndrome
Austrian syndrome