What is Meniere’s Disease and Treatment
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Meniere’s Disease?
Meniere’s disease is a condition affecting the inner ear, which is responsible for both hearing and balance. Meniere’s disease can lead to dizzy spells or vertigo, and loss of hearing. It can occur in either ear, although it commonly affects only one ear. Meniere’s disease usually starts between youth and middle age, although it can occur at any age. Meniere’s disease is a chronic (long-term) disorder and the different treatments can help in relieving its symptoms. In this article, we will be discussing in detail about Meniere’s disease and its treatments.
- What are the causes of Meniere’s Disease?
- What are the symptoms of Meniere’s Disease?
- What are the stages of Meniere’s Disease?
- How to diagnose Meniere’s Disease?
- What is the treatment for Meniere’s Disease?
- What are the complications of Meniere’s Disease?
- How to prevent Meniere’s Disease?
What are the causes of Meniere’s Disease?
- The exact cause of Meniere’s disease is not known.
- It occurs due to the presence of an abnormal amount of fluid, known as endolymph, in the inner ear called the labyrinth. However, the cause of why this happens is not clear.
- The extra fluid causes disturbances with the signals that the brain receives, leading to hearing problems and vertigo.
- Factors that could affect the fluid, leading to Meniere’s disease include:
- Allergic reactions
- Viral infection
- Blockage or presence of abnormal structure in the ear causing poor drainage
- Autoimmune disorder (when the body’s defense system attacks the healthy cells of the body)
- Inherited condition
- Trauma or injury to the head
- Migraine headaches
- Meniere’s disease could occur due to a combination of the above factors.
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What are the symptoms of Meniere’s Disease?
The symptoms of Meniere’s disease are:
- Vertigo: A spinning sensation that starts and stops suddenly is known as vertigo. Vertigo can last for 20 minutes to several hours, but not more than 24 hours. Severe vertigo can lead to nausea.
- Hearing loss: Hearing loss can be temporary early on, and can come and go. In the later stages of Meniere’s disease, most people suffer from some permanent hearing loss.
- A feeling of fullness in the ear: One may feel pressure in the affected ear. This is known as aural fullness.
- Tinnitus: Tinnitus or ringing in the ear is a condition of hearing a ringing, roaring, whistling, buzzing, or hissing sound in the ear.
Other symptoms may include:
- Blurred vision
- Nausea
- Diarrhea
- Anxiety
- Trembling
- Rapid pulse rate
- Cold sweat
( Know more about- What is Vertigo? Treatment of Vertigo )\
What are the stages of Meniere’s Disease?
The various stages of Meniere’s disease are:
- Early-stage:
- A person experiences sudden episodes of vertigo in this stage that can last from 20 minutes to 24 hours.
- The affected ear may feel full or blocked.
- The person may have some hearing loss, which usually disappears once the episode fades.
- One may also experience tinnitus.
- Middle stage:
- The symptoms of vertigo become less severe in the middle stage.
- Tinnitus and hearing loss increase in severity.
- For many people, the condition will disappear for several months altogether.
- Late-stage:
- The person will not suffer from frequent episodes of vertigo. For some people, it may disappear forever.
- Hearing loss and tinnitus get progressively worse.
- The balance of an individual becomes unsteady.
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How to diagnose Meniere’s Disease?
- Physical examination: The patient will be examined physically by the doctor. The symptoms of the patient are noted, along with the medical history and family history of the patient. The doctor will diagnose Meniere’s disease when the patient has the following:
- At least two episodes of vertigo, which may last for 20 minutes to 12 hours
- A feeling of fullness in the ear or tinnitus
- Hearing loss, confirmed by a hearing test
- Exclusion of other causes that could lead to the above symptoms
- Audiometry: This is a hearing test done for the assessment of how well one can detect the sounds at different volumes and pitches, and the ability to distinguish between similar-sounding words.
- Electronystagmogram: This is a test done for the evaluation of balance. The patient’s eye movements are measured as cool and warm air is blown through the ear canal in a darkened room.
- Electrocochleography: This test measures the pressure of fluid in the inner ear.
- Rotary chair testing: The patient is made to sit in a rotating chair that is controlled by a computer. The doctor will check how eye movement affects your inner ear.
- Posturography: This test is done to check the balance of the patient. The patient is made to stand barefoot with a harness on a platform that is able to move in various directions. The doctor will check how the patient responds when the platform is moved in certain directions.
- Vestibular-evoked myogenic potential (VEMP): This test measures the patient’s reaction to loud and sudden noises.
- Video head impulse test (VHIT): This test uses video images to check how well a person can focus and how the response of the eyes to sudden movement.
- Auditory brainstem response test (ABR): The patient is made to wear headphones, and a computer is used for measuring the brain waves as the person responds to different sounds. It is usually used in people who cannot undergo other hearing tests (like small children) or cannot have other imaging tests.
- Other tests: The doctor may recommend blood tests, or imaging tests like CT scans and MRI scans to rule out any other conditions that could be causing the symptoms.
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What is the treatment for Meniere’s Disease?
There is no treatment for Meniere’s disease. However, the symptoms of the condition can be treated by the following means:
- Medications for vertigo: The following medications can be used to reduce the severity of a vertigo episode:
- Motion sickness medicines: Medicines like diazepam or meclizine can help in reducing the spinning sensation and help in controlling nausea and vomiting.
- Anti-nausea medicines: Medicines like promethazine help in controlling nausea and vomiting that occurs during a vertigo episode.
- Long-term use of medications: The doctor may prescribe medications for reducing the retention of fluids (diuretics) and suggest limiting the intake of salt. This combination may help in reducing the frequency and severity of the symptoms of Meniere’s disease.
- Non-invasive procedures: Certain non-invasive procedures help in relieving the symptoms of Meniere’s disease, which include:
- Hearing aid: A hearing aid may help to improve the hearing of a patient with Meniere’s disease. You can discuss with your audiologist the various hearing aid options available.
- Rehabilitation: In case of balance problems between vertigo episodes, vestibular rehabilitation therapy may help in the improvement of balance.
- Positive pressure therapy: In case of vertigo that is difficult to treat, this form of treatment involves the application of pressure to the middle ear to lessen the buildup of fluid. A device known as a Meniett pulse generator is used to apply pulses of pressure to the ear canal by a ventilation tube. This treatment can be done at home, normally three times a day for five minutes each.
- Middle ear injections: Some medications may be injected into the middle ear, and then absorbed into the inner ear for the improvement of the symptoms of vertigo. The middle ear injections that can be given include:
- Gentamicin: This is an antibiotic that is toxic to the inner ear, reducing the function of balancing of the affected ear, and the other ear will take over this responsibility. However, it has a risk of causing further loss of hearing.
- Steroids: Steroids like dexamethasone help to control the episodes of vertigo.
- Surgery: Surgery may be an option if other treatments fail to work, or the condition is severe. The surgical procedures include:
- Endolymphatic sac procedure: The endolymphatic sac is the non-sensory organ of the inner ear, which plays an important role in the regulation of the inner ear fluid levels. The endolymphatic sac is decompressed during the procedure, which can alleviate the excess fluid levels. In some cases, a tube known as a shunt is placed to drain the excess fluid from the inner ear.
- Vestibular nerve section: This is a procedure of cutting the vestibular nerve that connects the movement and balance sensors in the inner ear to the brain. This procedure is normally performed under general anesthesia (the patient is put to sleep during the procedure) and helps in correcting the problems associated with vertigo while preserving the hearing of the affected ear.
- Labyrinthectomy: The surgeon removes the balance and hearing function from the affected area using this procedure. It is recommended only in cases of total or near-total hearing loss in the affected ear.
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What are the complications of Meniere’s Disease?
The complications of Meniere’s disease could include:
- Sudden onset of vertigo
- Permanent loss of hearing
- Interrupted social life and work-life
- Stress
- Fatigue
- Increased risk of accidents and falls due to loss of balance
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How to prevent Meniere’s Disease?
Meniere’s disease cannot be prevented, but a few lifestyle changes can help in reducing the amount of fluid in the inner ear and easing the symptoms of Meniere’s disease, which include:
- Limit or exclude the consumption of salt, caffeine, alcohol, chocolate, monosodium glutamate (MSG) from your diet
- Drink plenty of fluids throughout the day
- Take rest during vertigo attacks
- Eat regularly, which helps in the regulation of the body fluids
- Manage stress
- Quit smoking
- Avoid any allergens
- Do not drive if you are feeling dizzy
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We hope that we could answer all your questions regarding Meniere’s disease and its treatment through this article.
If you need more information and treatment of Meniere’s disease, you can contact an ENT surgeon.
We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan.
