Hi

Thanks for the query

Surgery is indicated for Ménière disease when it is refractory to medical management. Failure to respond to medical treatment for a period of 3-6 months is an indication for surgery. Before taking up the case for surgery any underlying medical causes of Ménière syndrome should be treated.

Betahistine (Vertin) 24 mg a day is not the appropriate dose for treating Meniere's disease. It should be at least 48 mg a day for 3-6 months. Secondly, you will require antidiuretic medicines and restriction of salt in the diet. Also, other medical cause such as hypertension has to be ruled out.

Various surgical procedures have evolved for the treatment of Ménière's disease patients who are refractory to medical therapy. It can be either a conservative surgery or destructive procedures. Conservative therapy in the form of intratympanic therapy with gentamycin and steroids has evolved as new methods for the treatment of Ménière's disease. Destructive procedures include labyrinthectomy and vestibular nerve section. Above procedures are decided depending upon the disability score and percentage of hearing.

Recovery from Meniere's disease is difficult but, we can prevent from further worsening by taking the appropriate steps as mentioned above. In your situation, I would recommend to request your doctor to increase the dose of betahistine as well as include antidiuretics. If it does not improve in a couple of months, you can request for intra-tympanic injection of gentamycin or steroids.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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