Pathophysiological Mechanisms and Multimodal Therapeutic Strategies in Menieres Disease

Meniere's disease is a long-term inner ear condition that leads to vertigo, hearing loss, and tinnitus. It affects primarily women between the ages of 40 and 60 years. It is hard to treat due to its numerous causes. Research has indicated that issues like fluid buildup in the inner ear, immune system attacks, and reduced blood flow could all play a role. Diagnostic tests like vascular endothelial function testing (VEMP), electrocorticography (ECoG), and 3T magnetic resonance imaging (MRI) can assist, but all have drawbacks and are frequently utilized together. Treatment strategies encompass diuretic therapy, intratympanic injections, vestibular rehabilitation, neuromodulation, and immunomodulatory interventions. However, no single modality has proven universally effective; physicians must therefore implement individualized, combination-based treatment regimens. This review delineates the principal pathogenic mechanisms of Menieres disease and critically evaluates a range of therapeutic approaches, highlighting the importance of personalized treatment algorithms and multidisciplinary care models to optimize patient outcomes in Menieres disease management.