Is it possible to consider non-conventional proposals for treating Ménière's disease?

Abstract

According to our model, the primum movens for the onset of Ménière's disease should be represented by a haemodynamic imbalance. From this starting point, the principal therapeutic approach should concern the necessity of achieving and maintaining a stable blood perfusion to the inner ear; this involves a number of different factors ranging from cardiac pump activity to vasomotor regulation that in turn exert an influence on membrane and cell integrity. A simple, alternative or coadjuvant and almost risk-free treatment can thus be represented by antioxidants such as melatonin, especially through its modulating activity on the autonomic nervous system, and mostly by omega-3 polyunsaturated fatty acids (omega-3 PUFAs); the latter, owing to their capability of improving myocardial function and arterial compliance, modulating blood pressure, and stabilizing cell and organelle membrane structure and function could theoretically fulfil all the requirements. When considering a resort to more strictly pharmacological principles, the hypothesis of some possible benefit deriving from commercially available proton pump inhibitors has been advanced. Moreover, an aspect that in our opinion deserves some interest, is the role of angiogenesis; a series of analogies permits the hypothesis of a similar role for the eye and the ear, thus opening a matter of debate on the possibility to apply to the labyrinth the same principles that have proved useful in treating degenerative retinopathy.

Key words::

• Ménière's disease
• melatonin
• omega-3 polyunsaturated fatty acids
• proton pump inhibitors
• antiangionetics

Declaration of interest: The authors have no conflicts of interest in this paper.