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Understanding Ménière's disease
Ménière's disease is a chronic disorder of the inner ear that causes sudden attacks of vertigo, along with hearing loss, tinnitus and a feeling of fullness in the ear. It usually starts in one ear and is linked to a build-up of fluid in the inner ear, known as endolymphatic hydrops.
Source: National Institute on Deafness and Other Communication Disorders (NIDCD)
Four symptoms, arriving without warning
Spinning attacks that last from 20 minutes to 12 hours, often with nausea and vomiting.
Fluctuates early on, usually in the low tones, and can become permanent as the disease progresses.
Ringing, roaring or buzzing in the affected ear, often louder around an attack.
Pressure or a blocked feeling in the ear, sometimes the first sign that an attack is coming.
Based on the diagnostic criteria for Ménière's disease published by the Bárány Society (2015).
A disease you plan your life around
The symptoms are only part of it. Because attacks come without warning, many people with Ménière's reorganize work, travel and family life around the possibility of the next one.
Unpredictable
Attacks can strike at work, while driving or in the middle of the night, with no reliable warning.
Disabling
During an attack most people cannot stand or walk and need to lie still until it passes. Some experience sudden drop attacks and fall.
Isolating
Fear of the next attack leads many people to avoid driving, travel and social plans. Anxiety between episodes is common.
Progressive
Over time, hearing in the affected ear can decline permanently, and the disease can come to affect both ears.
Every option is either off-label or destructive
Treatment usually escalates step by step. When the first options stop controlling vertigo, the remaining ones work by damaging the balance function of the ear, or its hearing.
Diet and lifestyle
Low-salt diet and limits on caffeine and alcohol, aimed at reducing fluid build-up.
Oral medication
Diuretics and anti-vertigo drugs for attacks. Betahistine, used widely abroad, is not approved in the US.
Steroid injections
Steroids injected through the eardrum. Never developed or approved for the ear, and often repeated.
Gentamicin injections
An antibiotic injected to destroy balance function in the affected ear, with a risk to hearing.
Surgery
Procedures that cut the balance nerve or remove the inner ear's balance organ. Labyrinthectomy ends hearing in that ear.
There is no FDA-approved drug for Ménière's disease. That is the gap Spiral is working to close.
Treating the inner ear where the disease is
Spiral is developing SPT-2101, an investigational dexamethasone otic suspension that forms a crosslinked hydrogel at the round window membrane, the entry point to the inner ear. It is placed under direct visualization with MICS™ (Minimally Invasive Cochlear System), by intratympanic administration in the clinic under local anesthesia.
Local
Delivered to the round window membrane, not taken by mouth or injected blind through the eardrum.
Visualized
The MICS Applicator's camera lets the physician see exactly where the formulation is placed.
In clinic
Performed under local anesthesia, with no operating room.
SPT-2101 is investigational and has not been approved by the FDA or any other regulatory authority.
Support and information for patients
Vestibular Disorders Association (VeDA)
Patient education, support networks and advocacy for people with balance disorders. Spiral works with VeDA on patient-centric care in neurotology.
vestibular.org Patient charityMénière's Society
Information, helplines and community for people living with Ménière's disease and other vestibular conditions.
menieres.org.uk NIHNIDCD: Ménière's disease
An overview of causes, symptoms, diagnosis and research from the US National Institutes of Health.
nidcd.nih.govThis page is for general information and is not medical advice. For questions about our programs or clinical studies, contact us.