Meniere’s disease is a chronic vestibular disorder caused by fluctuating pressure of inner ear fluid. It presents with recurrent episodes of spinning with fluctuating hearing loss in one ear. It is a slowly progressive disease which should be treated at the earliest to prevent long-term complications. Increased fluid pressure causes the inner ear to expand like a balloon which leads to recurrent episodes of vertigo, hearing loss, ringing sound in the ear (tinnitus). Meniere’s disease can develop at any age, but it is more likely to occur in people of the age of 30–60 years.
Symptoms
Vertigo: The most bothersome complaint in Meniere’s disease is unpredictable recurring episodes of vertigo which may last for about 20 minutes to several hours. The vertigo bouts are often accompanied by nausea and vomiting.
Hearing Loss: Fluctuating hearing loss in one ear is one of the earliest symptoms of Meniere’s disease. As the disease progresses, the temporary hearing loss may become a permanent disability.
Tinnitus (ringing in the ear): Tinnitus is a perceived sound of ringing or buzzing in the ear. In the initial stages, the sound may come and go but with disease progression, the sound may become a constant feature.
Fullness in the ear: Patients suffering from Meniere’s disease often feel pressure in the affected ear (aural fullness) or on the side of their heads before the spell of vertigo starts. This feeling may decrease after the vertigo spell subsides.
Diagnosis
A detailed history followed by thorough Vestibular Evaluation and Audiometry will help the doctor reach the diagnosis and stage of disease. According to the test results, the treatment is planned.
The treatment for Meniere’s disease focuses on relieving the symptoms of the disease, reducing inner ear pressure and preventing disease progression. This would be achieved through various measures –
Dietary modifications.
Medication are aimed to:
Control the vertigo attack
Reduce inner ear pressure
Treat the disease pathology
Vestibular Rehabilitation Therapy: Once the acute symptoms are controlled, the patient can be assisted with customized vestibular rehabilitation treatment.
Intratympanic Injections: In patients who do not respond well to medical management, we offer intratympanic injections in the form of steroids and gentamicin. This helps to reduce inner ear pressure by providing a higher concentration of drug locally in the ear without systemic side effects.
Hearing Aids: When hearing loss becomes constant and affects the day-to-day life of the patient, hearing aids can be used to improve hearing outcomes.
Surgery: Surgery is rarely indicated in Meniere’s disease. It remains one of the last options to treat intractable Meniere’s disease when the vertigo episodes are severe and frequent.
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