Diuretics (drugs which reduce fluid accumulation in the body) are commonly used in the management of the symptoms of vertigo, hearing loss, tinnitus or aural fullness in patients with Ménière's disease. 'Endolymphatic hydrops' is an increase in the pressure of the fluids in the chambers of the inner ear and is thought to be the underlying cause of Ménière's disease. Diuretics are believed to work by reducing the volume (and therefore also the pressure) of these fluids. The authors of this systematic review carried out an extensive search but could not identify any randomised controlled trials of sufficient quality to include in the review. There is no good evidence about the effect of diuretics on the symptoms of Ménière's disease and further research is needed.
There is insufficient good evidence of the effect of diuretics on vertigo, hearing loss, tinnitus or aural fullness in clearly defined Ménière's disease.
This is an update of a review first published in The Cochrane Library Issue 3, 2006.
Ménière's disease is a disorder characterised by hearing loss, tinnitus and disabling vertigo. Diuretics are used to try to reduce the severity and frequency of episodes but there is little evidence behind this treatment.
To assess the effect of diuretic treatment in patients with Ménière's disease.
We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 16 April 2009.
Randomised controlled trials of diuretic versus placebo in Ménière's patients.
Search results from the original and update searches were screened independently. We retrieved full text of potentially relevant articles and applied the inclusion criteria. Ten studies were excluded from the review due to inappropriate study design or absence of randomisation.
There were no trials of high enough quality to meet the standard set for this review.