Ménière’s disease is an inner ear disorder that causes fluctuating hearing loss, tinnitus, vertigo and fullness or pressure in the ear. It is the result of excess fluid in the inner ear, a condition called endolymphatic hydrops.
What Causes Ménière’s Disease?
The exact cause of Ménière’s disease is unknown. It is believed to be associated with a dysfunction of the endolymphatic sac, an organ responsible for regulating the volume and pressure of fluid in the inner ear. Various theories point to circulation disorders: viral infections, head trauma, allergies, migraines and improper fluid drainage from an obstruction or anatomic abnormality of the inner ear are possible causes.
It is estimated that Ménière’s disease affects about one out of every 1,000 people, with most patients between the ages of 40 and 60.
What Are the Symptoms of Ménière’s Disease?
People with Ménière’s disease suffer attacks of vertigo that are often characterized by warning signs in advance. These include loss of balance, dizziness, headache, increased hearing loss and/or tinnitus, sensitivity to noises, and pressure in the ear. During the attack, you may experience episodes of severe vertigo, fluctuating hearing loss, fullness in the ear, and tinnitus. These symptoms may be accompanied by anxiety, blurry vision, nausea, vomiting, trembling, and rapid pulse.
Afterwards, exhaustion often sets in, leading to an increased need for sleep. Attacks may be brief, lasting for as little as 20 minutes, or may persist for as long as 24 hours. Their frequency is unpredictable and sporadic; they may occur several times a week, or as little as once every few years. Meniere’s disease can be unpredictable, and the number and frequency of attacks can increase or decrease over time. Seeking medical care will help to minimize the impact of Meniere’s disease on your life.
How Is Ménière’s Disease Diagnosed?
In order to diagnose Meniere’s disease, your doctor will take a detailed history of the frequency, duration, severity and characteristics of your symptoms. Because the symptoms of Ménière’s disease resemble those associated with other conditions, your doctor will order a hearing test and other possible tests to evaluate the function of the inner ear in order to make a diagnosis. An audiogram will often show hearing loss in the low tones, a key indicator of Ménière’s disease. In some cases, imaging scans are ordered to rule out other causes of your symptoms. Additional tests can help support a diagnosis or eliminate other causes of your symptoms, but there is no definitive test for Meniere’s disease.
How Is Ménière’s Disease Treated?
Medical options for treating Ménière’s include diuretics, anti-nausea and motion sickness medications during attacks of vertigo, or oral steroids. Injectable steroids or injecting an antibiotic called gentamicin may be offered by your doctor for more severe cases. Medical treatment coupled with a low-sodium diet can help prevent dizziness or reduce the severity of attacks.
Other lifestyle remedies include limiting caffeine, alcohol, chocolate and monosodium glutamate from your diet; drinking six to eight glasses of water per day; quitting smoking; avoiding allergens; and reducing stress and anxiety.
Vestibular rehabilitation, a special form of therapy used to improve balance related to inner ear issues, can help patients with imbalance. Hearing aids will help treat hearing loss associated with Ménière’s.
Individuals who experience severe attacks and are unable to find relief from other treatments may have success with surgery. Procedures that have proven effective include an endolymphatic sac procedure to relieve pressure in the inner ear, a vestibular nerve section to cut the nerve that connects the ear and brain to eliminate dizziness and preserve hearing, and a labyrinthectomy to control dizziness.
Call River ENT at (512) 677-6368 for more information or to schedule an appointment.