Meniere’s disease is a disorder of the inner ear that can cause vertigo (dizziness) and hearing loss. It typically affects one ear and can occur at any age, usually starting in young to middle-aged adults. While it is a chronic condition, there are various treatments available to manage symptoms and minimize long-term impact.
Symptoms of Meniere’s disease include:
Recurring episodes of vertigo: Sudden spinning sensations that start and stop spontaneously, lasting from 20 minutes to several hours, but not exceeding 24 hours. Severe vertigo can lead to nausea.
Hearing loss: Hearing loss may come and go, particularly in the early stages, but most people experience some permanent hearing loss over time.
Tinnitus: Perception of ringing, buzzing, roaring, whistling, or hissing sounds in the ear.
Feeling of fullness in the ear: A sense of pressure or fullness in the affected ear.
After an episode, symptoms improve and may disappear for a while. Over time, the frequency of episodes may decrease.
The exact cause of Meniere’s disease is unknown, but it appears to be related to abnormal fluid levels (endolymph) in the inner ear. Factors that may contribute to this imbalance include improper fluid drainage, immune system abnormalities, viral infections, and genetic predisposition. The condition is likely the result of a combination of these factors.
Meniere’s disease can have several complications. The unpredictable vertigo episodes and the potential for permanent hearing loss can significantly impact a person’s life, causing fatigue and stress. Vertigo can also increase the risk of falls and accidents.
To diagnose Meniere’s disease, a doctor will conduct a physical examination and review medical history. The diagnosis requires two episodes of vertigo lasting 20 minutes or longer but not exceeding 12 hours, verified hearing loss through a hearing test, tinnitus or a feeling of fullness in the ear, and exclusion of other possible causes.
Hearing assessments, such as audiometry, evaluate the ability to detect sounds at different pitches and volumes. People with Meniere’s disease typically have difficulty hearing low frequencies or a combination of high and low frequencies, while their midrange hearing remains relatively normal.
Additional tests, such as blood tests and imaging scans (e.g., MRI), may be necessary to rule out other conditions that present similar symptoms, such as brain tumors or multiple sclerosis.
There is currently no cure for Meniere’s disease, but various treatments can help reduce the severity and frequency of vertigo episodes. Medications like motion sickness and anti-nausea drugs may be prescribed to manage vertigo symptoms during an episode. Long-term medication use may involve diuretics to reduce fluid retention and dietary changes to limit salt intake.
Noninvasive therapies and procedures can also be beneficial. Vestibular rehabilitation therapy can improve balance between vertigo episodes, while hearing aids can improve hearing in the affected ear. Positive pressure therapy, which applies pressure to the middle ear to reduce fluid buildup, may be performed at home using a device called a Meniett pulse generator.
If conservative treatments are unsuccessful, more aggressive options may be considered. Middle ear injections of gentamicin or steroids can improve vertigo symptoms but carry some risks, including further hearing loss. Surgical procedures like the endolymphatic sac procedure, labyrinthectomy, or vestibular nerve section may be recommended for severe and debilitating vertigo that does not respond to other treatments. These surgeries aim to alleviate excess fluid levels, remove the balance portion of the inner ear, or cut the vestibular nerve while preserving hearing in the affected ear.
It is important to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan for Meniere’s disease.