Meniere Disease

Definition

Meniere disease is a disorder of the inner ear. It results in repeat attacks of vertigo (a spinning sensation) and problems hearing. Treatment can help manage symptoms.

The Inner Ear.

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Causes

The exact cause is not known. It is thought to be caused by many things, such as:

• A buildup of fluid in the part of the inner ear known as the labyrinth
• Genetics
• Problems with the immune system
• Infection
• Trauma

Risk Factors

This problem is more common in people who are 30 to 60 years of age. Other things that may raise the risk are:

• Having other family members who have this health problem
• Pressure changes in the atmosphere
• Allergies
• Stress
• Changes in hormones
• Problems sleeping
• Dietary changes, such as an increase in salt, caffeine, or alcohol
• Excessive sweating followed by a sudden increase in fluids

Symptoms

Problems may come and go. They may also be in one or both ears. A person may have:

• A sensation of spinning while standing still
• Balance problems
• Nausea and vomiting
• A feeling of fullness or pressure in the ear
• Ringing in the ear(s)
• Problems hearing

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will focus on the ears. The person may be referred to a doctor who treats ears.

A hearing test will be done. Other tests may be done to make the diagnosis. They may include:

• MRI scan —to look at internal structures of the ear
• Electrocochleogram—to check function of the hearing organ in the inner ear
• Vestibular evoked myogenic potential test—to check muscle activity in response to sound
• Caloric testing—to check for nerve damage
• Glycerol dehydration test—to see whether hearing improves after using a dehydrating agent

Treatment

There is no cure. The goal of treatment is to manage symptoms. Options are:

• Medicines to:
  • Ease vertigo
  • Control nausea
  • Reduce fluid buildup
• Dietary changes, such as limiting salt, caffeine, and alcohol
• Lifestyle changes, such as reducing stress and safety measures to avoid falling
• Physical therapy to learn vestibular exercises—to get the body used to moving without vertigo
• A Meniett device that gives low-pressure pulses to the middle ear
• A counselor or support group to learn how to cope with symptoms

People who are not helped by these methods may need surgery, such as:

• Endolymphatic sac surgery—to remove of a portion of inner ear bone and drain excess fluid
• Labyrinthectomy—to destroy or remove the entire inner ear
• Vestibular nerve section—to cut the nerve in the ear that controls balance

Prevention

There are no known guidelines to prevent this health problem.