The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Micropressure therapy for refractory Ménière's disease.


Ménière's disease is a disorder of the inner ear that can affect hearing and balance, which gets worse over time. Symptoms vary in severity and usually start in one ear but can affect the other in time. The cause is not known but it is thought to result from a rise in pressure in the fluid that bathes the nerve endings in the inner ear. Medications and/or a low salt diet aim to treat symptoms (usually the loss of balance and dizziness) but if they fail, surgery can be used to reduce pressure in the inner ear and correct problems with balance. Micropressure therapy involves inserting a grommet (small tube) through the eardrum into the middle ear and blowing air at low pressure into the inner ear. This aims to reduce pressure in the ear, relieving symptoms and avoiding the need for more invasive surgery.

Coding recommendations

D23.8 Other specified operations on inner ear

In addition ICD-10 code H81.0 Ménière’s disease is assigned.

  • National Institute for Health and Care Excellence (NICE) accreditation logo