Introduction
Ménière’s disease is a chronic vestibular disorder characterised by episodic vertigo, fluctuating sensorineural hearing loss, tinnitus and aural fullness. Despite well-established clinical criteria, its pathophysiology remains elusive and treatment varies widely. A 2017 survey of US otolaryngologists highlighted reliance on diuretics, corticosteroids and intratympanic injections, with limited use of surgical interventions.Reference Clyde, Oberman and Isildak1 While surveys offer valuable insights into physician preferences, they are limited by response bias and lack of patient-level data. In contrast, large-scale real-world data from electronic medical records can offer more representative insights into how Ménière’s disease is managed across diverse patient populations. The TriNetX research network, comprising data from over 120 million patients, provides an ideal platform for such an investigation.
This study aimed to analyse treatment patterns, surgical trends, demographic disparities and co-morbidities in Ménière’s disease using TriNetX data.
Methods
We conducted a retrospective cohort analysis using the TriNetX global health research network, a federated database of de-identified records from over 100 US-based healthcare organisations. Patients diagnosed with Ménière’s disease (ICD-10: H81.0) from 1 January 2015 to 1 January 2024 were included. Data extracted included age, sex, race and/or ethnicity, prescribed medications (corticosteroids, diuretics, antihistamines, benzodiazepines, betahistine, antacids), surgical procedures (endolymphatic sac surgery, labyrinthectomy, vestibular nerve section, cochlear implantation) and co-morbidities.
Medication use, surgical rates and co-morbidity prevalence were reported as percentages with interquartile ranges. Co-morbidity prevalence was also determined in a manually aged-matched cohort of patients without Ménière’s disease restricted to an age range within 1 standard deviation (SD) of the mean age of the Ménière’s disease cohort (49–82 years old). Surgical and non-surgical cohorts were compared using t-tests for age and chi-square or Fisher’s exact tests for sex and race, with p less than 0.05 considered significant. Analyses were performed on the TriNetX platform and validated using standard statistical software.
Results
A total of 117,059 patients were identified (60.91 per cent female and 34.97 per cent male). The most common medications were corticosteroids (64 per cent), benzodiazepines (55 per cent), diuretics (52 per cent) and antacids (49 per cent); betahistine was used in only 6 per cent (Table 1). Surgical interventions comprised cochlear implantation (1314 patients, 1 per cent), endolymphatic sac operation (1219 patients, 1 per cent), labyrinthectomy (407 patients, 0.3 per cent) and vestibular nerve section (138 patients, 0.1 per cent) (Table 2). Surgical patients were significantly older (mean age 68.4 years, SD 14.6 vs 66 years, SD 15.7; p < 0.001) and differed in sex and race distributions (both p < 0.001; Table 3).
The most frequently prescribed medications for patients with Ménière’s disease, based on a cohort of 117,059 patients from the TriNetX database, reported as percentages of patients receiving each medication
Table 1 Long description
The table lists medications prescribed to patients with Ménière’s disease and the percentage of patients who received each drug in a large cohort. Corticosteroids are the most frequently used at 64 percent. Benzodiazepines and diuretics follow closely at 55 percent and 52 percent, and antacids or other gastrointestinal medicines are also common at 49 percent. Mid-range use includes antilipemic agents at 41 percent and meclizine at 33 percent. Less frequently prescribed medications are prochlorperazine at 13 percent, melatonin at 9 percent, scopolamine at 8 percent, and betahistine at 6 percent. Overall, the distribution shows a steep drop from the top three medications to the least used options. Percentages reflect prescribing or receipt in the database and do not indicate dose, duration, effectiveness, or whether medications were used specifically for Ménière’s symptoms.
Frequency and percentage of otological surgical procedures performed on Ménière’s disease patients, including cochlear implantation, endolymphatic sac surgery, labyrinthectomy and vestibular nerve section, based on TriNetX data
Table 2 Long description
The table reports counts and percentages of selected ear surgeries among patients with Ménière’s disease in a TriNetX dataset. Cochlear implantation has 1,314 cases, about 1 percent of patients. Endolymphatic sac surgery is similar with 1,219 cases, also about 1 percent. Less frequent procedures include labyrinthectomy with 407 cases, about 0.3 percent, and vestibular nerve section with 138 cases, about 0.1 percent. Vestibular nerve section is further split into 67 translabyrinthine and 71 transcranial cases, with the transcranial approach slightly higher. Percentages are provided only for the main surgery categories, so the approach breakdown should be interpreted as counts within the vestibular nerve section total.
Demographic characteristics (mean age, sex and race) of surgical and non-surgical Ménière’s disease patients, highlighting significant differences using p values from statistical tests
Table 3 Long description
The table compares demographics of Ménière’s disease patients who had surgery (1,804) versus those managed without surgery (101,009), reporting mean age and distributions of sex and race with p values for selected comparisons. Surgical cases had a higher mean age, 68.4 years (standard deviation 14.6), than non-surgical cases, 66.0 years (standard deviation 15.7), with a statistically significant difference. By sex, surgical cases included 44.29 percent male and 50.22 percent female, while non-surgical cases included 34.62 percent male and 60.68 percent female; both male and female comparisons were statistically significant. Sex was unknown for 5.49 percent of surgical cases and 4.70 percent of non-surgical cases, with no p value reported. For race, White patients were the largest group in both cohorts (68.84 percent surgical; 66.71 percent non-surgical), and race was unknown more often in surgical cases (24.94 percent) than non-surgical cases (16.30 percent); p values were not provided for these rows. Asian and African American patients made up smaller shares in surgical cases (1.55 percent and 1.99 percent) than in non-surgical cases (8.29 percent and 4.43 percent), and these differences were statistically significant. Interpret results cautiously because several race categories are not shown and missing or unknown race is substantial, especially in the surgical group.
SD = standard deviation.
Specifically, surgical patients were more likely to be male (44.29 per cent vs 34.62 per cent, p < 0.001) and less likely to be Asian (1.55 per cent vs 8.29 per cent, p < 0.001) or African American (1.99 per cent vs 4.43 per cent, p < 0.001). For comparison, the average age of all patients on the TriNetX database was 45.8 years and 46.31 per cent were male, 5.47 per cent were Asian and 11.72 per cent were African American. Common co-morbidities included musculoskeletal disorders (69 per cent), metabolic disorders (56 per cent), hypertension (50 per cent), anxiety and/or depression (48 per cent), gastroesophageal reflux disease (35 per cent), sleep disorders (28 per cent), thyroid disorders (25 per cent) and migraine (19 per cent). Interestingly, the melanoma prevalence in Ménière’s disease patients was 6 per cent. Each co-morbidity was more frequently observed in patients with Ménière’s disease compared with those without Ménière’s disease (Table 4).
Prevalence of common co-morbidities among Ménière’s disease patients and an age-matched cohort without Ménière’s disease, including musculoskeletal, metabolic, hypertensive, mental health and other systemic conditions, with detailed subcategories and percentages from the database
Table 4 Long description
The table compares the percentage of people with various co-morbidities in a Ménière’s disease group versus an age-matched group without Ménière’s disease. Across nearly all listed conditions, prevalence is higher in the Ménière’s group. Musculoskeletal or connective tissue disorders are most common at 69 percent in Ménière’s versus 35 percent in controls, including dorsalgia at 39 versus 14 and limb pain at 27 versus 8. A metabolic category total is 56 percent versus 22, with lipid disorders at 49 versus 18, electrolyte or acid-base disorders at 19 versus 6, hypokalaemia at 11 versus 3, and hyponatremia or hypo-osmolality at 7.7 versus 2. Hypertensive diseases are 50 percent in Ménière’s versus 24 in controls. Mental health conditions are also higher, with a total of 48 versus 18, including anxiety at 33 versus 9 and depression at 22 versus 6. Other notable differences include gastroesophageal reflux disease at 35 versus 10, sleep disorders at 28 versus 8, thyroid disorders at 25 versus 7 with hypothyroidism at 18 versus 5, vasomotor and allergic rhinitis at 22 versus 4, migraine at 19 versus 2, and diabetes mellitus at 20 versus 11. Smaller but still higher rates appear for asthma at 15 versus 4, head injuries at 15 versus 5, and melanoma at 6 versus 2. Percentages indicate prevalence in the database and do not establish that Ménière’s disease causes these conditions.
Discussion
This study presents one of the largest real-world analyses of Ménière’s disease to date, leveraging the TriNetX platform to examine over 117,000 patients. It provides a granular view of treatment patterns, surgical trends, demographic disparities and co-morbidities. These findings not only corroborate previously reported trends but also uncover new insights, particularly regarding the systemic nature of Ménière’s disease and its associations with various non-otological conditions.
What are the most-used medications for patients with Ménière’s disease?
Corticosteroids (64 per cent), benzodiazepines (55 per cent) and diuretics (52 per cent) were the most frequently prescribed medications, consistent with guideline-based interventions targeting inflammation, vertigo control and fluid balance.Reference Basura, Adams, Monfared, Schwartz, Antonelli and Burkard2 Because of the nature of the standardised coding within the TriNetX database, a granular distinction between systemic and intratympanic corticosteroid delivery could not be determined. Future studies utilising specific procedure codes or clinical note processing are required to further delineate these treatment pathways.
Additionally, betahistine use was low (6 per cent), probably because of its off-label status in the USA and lack of inclusion in electronic prescribing systems, contrasting with more than 90 per cent use in Europe.Reference Smith, Sankar and Pfleiderer3
Notably, antacids (49 per cent) and gastroesophageal reflux disease (35 per cent) were highly prevalent, exceeding general population estimates (gastroesophageal reflux disease, 18–28 per cent; antacid use, 10–15 per cent).Reference El-Serag, Sweet, Winchester and Dent4, Reference Yu, Taitel and Mosley5 This suggests a potential link between Ménière’s disease and autonomic dysfunction, possibly via vagal nerve dysregulation affecting both inner-ear fluid dynamics and gastric acid production.Reference Takeda, Morita and Hasegawa6 Proton pump inhibitors, commonly used for gastroesophageal reflux disease, may also influence vestibular function through magnesium depletion, warranting further study.Reference Park, Kim and Lee7
Which otological surgical procedures are most frequently performed?
Surgical interventions were rare, with endolymphatic sac surgery and cochlear implantation each at approximately 1 per cent. Endolymphatic sac surgery, despite historical controversy over its efficacy (sometimes labelled a ‘sham’ procedure in early studies), remains a preferred option because of its non-ablative nature and potential to preserve hearing.Reference Sood, Lambert, Nguyen and Meyer8 Its prominence in this cohort reflects its role in managing refractory vertigo while avoiding more invasive procedures like labyrinthectomy (0.3 per cent) or vestibular nerve section (0.1 per cent).
Cochlear implantation has emerged as a leading procedure for Ménière’s disease, addressing progressive, profound hearing loss due to endolymphatic hydrops and, notably, reducing disabling vertigo spells in many patients.Reference Carlson, Driscoll and Gifford9 Studies, including Lustig et al. and Plinkert et al., report significant vertigo improvement post-cochlear implantation (e.g. 37.9–15.4 per cent prevalence), possibly via modulation of endolymphatic pressure or vestibular neural pathways, although outcomes vary.Reference Lustig, Yeagle and Niparko10–Reference Merchant, Adams and JB12 The Food and Drug Administration’s 2019 approval for single-sided deafness has expanded cochlear implantation candidacy, which is likely to have made it the most common otological surgery in Ménière’s disease patients by offering an alternative to ablative procedures such as labyrinthectomy.
Are there demographic differences between surgical and non-surgical patients?
Surgical patients were more likely to be male (44.3 per cent vs 34.6 per cent) and less likely to be Asian (1.6 per cent vs 8.3 per cent) or African American (2.0 per cent vs 4.4 per cent). The overall cohort showed a female predominance (60.91 per cent female and 34.97 per cent male), consistent with Ménière’s disease’s epidemiology, which typically affects women more frequently (female: male ratio, ∼1.7:1). Although Ménière’s disease is less common in males (female predominance, ∼1.5:1), males may experience more severe or refractory symptoms, prompting surgical intervention.Reference Lopez-Escamez, Carey, Chung, Goebeld, Magnussone and Mandalàf13 Data on severity by sex are limited, but worse hearing outcomes in males have been reported.Reference Paparella and Djalilian14 For Asian and African American patients, lower surgical rates may reflect reduced disease severity or better control with medical treatment, healthcare access barriers or cultural preferences for non-surgical management. Ménière’s disease prevalence is lower in Asian populations, but severity data are sparse.Reference Lopez-Escamez, Carey, Chung, Goebeld, Magnussone and Mandalàf13
What are the common co-morbidities associated with Ménière’s disease?
The high burden of systemic co-morbidities in Ménière’s disease patients underscores its multisystem nature, with overlapping proposed mechanisms for its pathogenesis including immune dysregulation, vascular dysfunction, metabolic imbalance, neurological pathways, autonomic dysregulation, hormonal influences, non-autoimmune inflammation and biomechanical factors. Each co-morbidity’s role as a source (contributing to Ménière’s disease), result (consequence of Ménière’s disease) or related factor (shared pathophysiology) is explored in the following sections, emphasising bidirectional relationships and systemic effects that may drive or amplify endolymphatic hydrops.
Musculoskeletal disorders (69 per cent)
Chronic vertigo in Ménière’s disease may cause compensatory postures, leading to dorsalgia (39 per cent) and limb pain (27 per cent).Reference Reilly, Wiet and Wyatt15 Cervical spine dysfunction may act as a source by disrupting proprioceptive input to the vestibular system, triggering vertigo via biomechanical and neurological pathways.Reference Derebery16 Inflammatory and autoimmune mechanisms in conditions like rheumatoid arthritis, alongside vascular compromise in degenerative joint disease, may related to the inner-ear hydrops.Reference Merchant, Adams and JB12, Reference Derebery16
Metabolic disorders (56 per cent)
Lipid disorders (49 per cent) and electrolyte imbalances (19 per cent) serve as a source, promoting vascular damage and oxidative stress that potentially impair endolymphatic sac function and cause hydrops.Reference Lee, Kim and Kim17 Chronic inflammatory pathways (e.g. interleukin (IL)-6, tumour necrosis factor-α) in metabolic syndrome are a related factor, amplifying inner-ear inflammation.Reference Kim, Lee and Min18 Diuretic therapy for Ménière’s disease may induce electrolyte disturbances (e.g. hypokalaemia, 11 per cent) as a result, reflecting metabolic overlap.Reference DeFronzo19
Hypertension (50 per cent)
As a source, hypertension causes vascular microvascular changes, reducing inner-ear perfusion and triggering hydrops through ischaemic inflammation.Reference Merchant, Adams and JB20
Anxiety and/or depression (48 per cent)
Primarily a result of Ménière’s disease’s episodic vertigo and hearing loss, these conditions cause psychological stress.Reference Yilmaz, Yildirim and Ozcan21 Chronic stress may act as a source, upregulating inflammatory cytokines (e.g. cortisol-driven IL-6) via neurological pathways, exacerbating hydrops.Reference Staab and Ruckenstein22 Neuroinflammatory and autonomic dysregulation (e.g. heightened vestibular sensitivity) are related factors, forming a feedback loop with Ménière’s disease.Reference Staab and Ruckenstein22, Reference Takeda23
Gastroesophageal reflux disease (35 per cent)
While there is no definitive proof of a causal link, a potential association between gastroesophageal reflux disease and Ménière’s disease has been observed in some studies. Gastroesophageal reflux disease is a related factor through autonomic vagal dysfunction, linking gastrointestinal and inner-ear fluid dysregulation.Reference Wang, Deng and Liu24 Chronic inflammatory pathways may act as a source, promoting inner-ear immune responses.Reference El-Serag, Sweet, Winchester and Dent4 Acid or pepsin reaching the nasopharynx could cause chronic inflammation or dysfunction in the Eustachian tube, impacting middle-ear pressure and possibly inner-ear fluid homeostasis. Proton pump inhibitors may cause magnesium deficiency, worsening vestibular function as a result via metabolic overlap.Reference Park, Kim and Lee7
Sleep disorders (28 per cent)
Studies have shown a high prevalence of sleep disturbances among Ménière’s disease patients. For instance, research indicates that approximately 40 per cent of individuals with Ménière’s disease experience inadequate sleep, characterised by poor quality, high arousal and reduced deep-sleep stages. These sleep issues may exacerbate Ménière’s disease symptoms, creating a negative feedback loop.Reference Nakayama, Suzuki, Inagaki, Takemura, Watanabe and Tanigawa25 Ménière’s disease vertigo and tinnitus cause poor sleep as a result.Reference Celik, Yalcin and Ozturk26, Reference Kim, Kim and Kim27
Some other studies suggest a multifaceted relationship between sleep disorders and Ménière’s disease, involving factors such as inflammation, oxidative stress, autonomic dysregulation and metabolic conditions. Sleep apnoea or insomnia may serve as a source via inflammatory (e.g. IL-1β) and oxidative stress pathways, impairing vestibular compensation.Reference Murdin and Schilder28 Autonomic dysregulation and neurological alterations (e.g. altered cortisol) are related factors, amplifying hydrops, with metabolic overlap (e.g. obesity in sleep apnoea) further linking these conditions.Reference Lee, Kim and Kim17
Thyroid disorders (25 per cent) and hypothyroidism (18 per cent)
Hypothyroidism, particularly autoimmune thyroid disease such as Hashimoto’s thyroiditis, has been associated with an increased risk of Ménière’s disease. Proposed mechanisms include hormonal imbalances affecting endolymphatic fluid regulation and autoantibody-mediated inner-ear damage. Population-based studies have identified hypothyroidism as an independent risk factor for Ménière’s disease, with some evidence suggesting that thyroxine therapy may alleviate symptoms, although causality is not definitively established. Additionally, inflammatory, metabolic and vascular (e.g. endothelial dysfunction) pathways may exacerbate endolymphatic hydrops, contributing to disease progression.Reference Merchant, Adams and JB12, Reference Hwang, Tsai and Liu29, Reference Hwang, Saadi, Patel, Liaw and Isildak30
Vasomotor and/or allergic rhinitis (22 per cent)
Allergic rhinitis is considered a potential contributor to endolymphatic sac dysfunction, primarily through immunoglobulin E-mediated inflammatory responses. This immunological mechanism may trigger inflammation that affects the structures of the inner ear, particularly the endolymphatic sac, which is crucial for maintaining fluid balance in the inner ear.Reference Derebery and Berliner31 Additionally, autoimmune and inflammatory mucosal responses have been proposed as significant contributors to the pathogenesis of Ménière’s disease, suggesting a shared immune profile between the two conditions.Reference Derebery16
Diabetes mellitus (20 per cent)
Some evidence suggests a correlation between diabetes mellitus and Ménière’s disease, particularly through mechanisms related to vascular and microvascular damage, as well as oxidative stress, which can contribute to hydrops in the inner ear. Diabetes can exacerbate the pathophysiology of Ménière’s disease by promoting microvascular damage in the cochlear and vestibular structures, leading to impaired fluid regulation and contributing to the hydrops seen in Ménière’s disease.Reference Bainbridge, Hoffman and Cowie32 Additionally, inflammatory cytokines, including IL-6, play a role in amplifying immune responses in the inner ear, potentially exacerbating the inflammatory component of Ménière’s disease. The chronic inflammation seen in diabetes may therefore be an important factor in disease progression.
Diuretic therapy may impair glycaemic control. Diuretics can induce electrolyte imbalances, particularly hypokalaemia, which has been shown to interfere with insulin secretion and action. Hypokalaemia may contribute to insulin resistance, exacerbating hyperglycaemia.Reference DeFronzo33 Furthermore, diuretics can reduce the renal clearance of glucose, potentially leading to a rise in blood glucose levels. This is particularly concerning in individuals with diabetes, as the combination of a pre-existing insulin resistance or impaired insulin secretion and the diuretic-induced effects can worsen glycaemic control.Reference Sica34 This all suggests a complex interplay between diabetes and Ménière’s disease, where metabolic and vascular factors, as well as treatment side effects, contribute to the overall disease burden.
Migraine (19 per cent)
The relationship between Ménière’s disease and migraine has been the subject of increasing interest because both conditions share several overlapping symptoms and pathophysiological mechanisms, particularly with respect to vestibular dysfunction and episodic nature. Epidemiologically, studies suggest that individuals with Ménière’s disease are at a significantly higher risk of experiencing migraines, and vice versa. The co-morbidity between Ménière’s disease and migraine has been documented in several cohort studies, with some estimates indicating that up to 30–40 per cent of patients with Ménière’s disease also report a history of migraine headaches.Reference Linthicum and Beasley35 Similarly, patients with chronic migraine are more likely to develop vestibular symptoms consistent with Ménière’s disease, such as vertigo and tinnitus.Reference Saqib, Giles and Kotecha36, Reference O’Connell, Priesol and Isildak37 This clinical overlap is especially pronounced in patients with vestibular migraine.Reference Baloh38
Ménière’s disease and migraine share common potential pathophysiological features, including altered vascular function, neural inflammation and a heightened sensitivity to stimuli in the central nervous system. Recent theories suggest that both conditions may share a vascular and neurological basis, with migraine potentially predisposing the inner ear to dysfunction through vascular effects or by altering the brain’s perception of vestibular input. This neurovascular dysregulation may link the vestibular symptoms of Ménière’s disease to the migraine process.Reference Charles39
Head injuries (15 per cent)
There are some reports indicating that traumatic injury can induce endolymphatic hydrops.Reference Chung, Jung, Kim and Kim40 Proposed pathophysiological mechanisms are presumed to disrupt perilymph–endolymph pressure regulation as a result of fistulation of the bony labyrinth, direct trauma to the membranous labyrinth, leading to increased endolymphatic fluid production secondary to irritation, and impaired endolymphatic drainage as a consequence of temporal bone fractures or iatrogenic damage involving structures such as the saccule. Patients with Ménière’s disease do have an increased risk of falls because of sudden vertigo episodes, and falls can result in head injury. However, whether such injuries contribute further to Ménière’s disease pathophysiology is speculative and would require stronger evidence.
Melanoma (6 per cent)
The prevalence in this study seems 12–15 times higher than the general US population, which is 0.4–0.5 per cent.Reference Faries, Thompson and Cochran41 There is no direct or epidemiologically supported correlation between melanoma and Ménière’s disease. Any suggested relationship is theoretical, potentially involving shared immune, melanocytic or treatment-mediated pathways. Of note, in our database-specific control, the prevalence of melanoma was 2 per cent (Table 4). While reporting bias within the TriNetX population likely contributes to a higher baseline rate compared with the general public, the 6 per cent prevalence within the Ménière’s disease cohort remains three times higher than our age-matched control. This suggests that while database characteristics must be considered, a significant and disproportionate clinical signal remains that warrants further investigation to clarify any mechanistic links.
This study, leveraging the expansive TriNetX database, provides a comprehensive analysis of Ménière’s disease management, surgical trends, demographic disparities and co-morbidities in a cohort of over 117,000 patients. The findings confirm corticosteroids, benzodiazepines and diuretics as the cornerstone of pharmacological management. Surgical interventions, particularly endolymphatic sac surgery and cochlear implantation, remain rare but cochlear implantation is gaining prominence possibly as a result of its dual benefits in addressing hearing loss and vertigo.
Demographic analyses reveal significant differences, with surgical patients more likely to be older and male, and less likely to be Asian or African American, suggesting potential influences of disease severity, healthcare access or cultural factors on treatment pathways. Multiple systemic co-morbidities exhibited high prevalence in Ménière’s disease compared with an age-matched control. These co-morbidities may contribute to Ménière’s disease, involving mechanisms such as immune dysregulation, vascular dysfunction and autonomic imbalance, which likely influence the development or progression of endolymphatic hydrops. Notably, the elevated prevalence of gastroesophageal reflux disease and antacid use, coupled with an unexpected 6 per cent melanoma prevalence, underscores novel associations that merit further investigation. While the prevalence of co-morbidities such as hypertension and migraine is significantly higher in the Ménière’s disease cohort compared with the age-matched control, these should be viewed as shared clinical associations or potential markers of systemic dysregulation rather than definitive causative factors.
A potential limitation of this study is its reliance on retrospective data from the TriNetX network, which may be affected by coding variability, incomplete documentation and lack of detailed clinical context such as symptom severity or diagnostic confirmation of Ménière’s disease. Additionally, the analysis does not account for treatment duration, medication adherence or longitudinal outcomes, which could influence interpretations of treatment efficacy. The TriNetX database also records the presence of a prescription within a patient’s electronic health record but does not link the medication to a specific diagnostic code. As such, we cannot definitely conclude that all identified medications were utilised specifically for the management of Ménière’s disease symptoms. Moreover, the rarity of surgical interventions also limits the ability to draw robust conclusions. Finally, while co-morbidities like melanoma are noteworthy, causality cannot be inferred from this observational design.
• Surgical patients are older, are more often male and are less likely to be Asian or African American
• Corticosteroids, benzodiazepines and diuretics dominate treatment
• Cochlear implantation is the most common surgery in this population, followed by endolymphatic sac surgery
• Markedly higher melanoma prevalence (6 per cent) warrant further research
Conclusion
Ménière’s disease patients are predominately treated medically with corticosteroids, benzodiazepines and diuretics, and rarely with surgical procedures. Surgical patients were found to be older, were more often male and were less likely to be Asian or African American. Co-morbidities found in higher proportions compared with an age-matched cohort included musculoskeletal disorders, hypertension, gastroesophageal reflux disease, thyroid disorders and migraine. There was also a notably higher melanoma prevalence, warranting further investigation.
