Recovery of Hearing in Meniere's Disease after Antiviral Treatment.

OBJECTIVE Determine the outcome of hearing in Meniere's Disease (MD) after antiviral treatment. STUDY DESIGN Prospective study. SETTING University Hospital. METHODS Thirty one new patients with a diagnosis of MD were treated with antiviral drugs during 2012. Acyclovir or valacyclovir was used depending on insurance coverage and cost. A standard dose of 800 mg (acyclovir) or 1g (valacyclovir) 3 times a day for 3 weeks was used. The dose was decreased to twice daily for three weeks, and finally once daily for a year or longer. Hearing test including pure tone average (PTA) and speech discrimination (SD) was performed prior to treatment and 1-2 months, 6 months and 1 year after the initiation of treatment. Effect on dizziness was recorded at each evaluation, hearing was judged to be improved if PTA was lowered by at least 15 db and/or an increase in SD of 20% or greater. RESULTS Hearing was improved in twelve and not improved in nineteen patients. Complete control of vertigo was achieved in those patients with improved hearing. The nineteen patients with no improvement in hearing were divided into 2 groups based on the level of hearing at diagnosis. Nine patients presenting with a PTA of 50 db and SD of 50% or better experienced good control of vertigo (6 out of 7; 2 with no follow-up). Ten patients with PTA of 60 db or more and SD below 50% exhibited poor control of vertigo with antivirals (3 out of 10). The duration of MD in the group with hearing improvement was shorter (2.4 years) than the group with no improvement (5.5 years). CONCLUSION Significant hearing and balance control in patients with MD can be achieved with orally administered antiviral drugs.