ENT - Ear Nose Throat- Meniere Disease

What is Meniere's disease?

Meniere's disease is a balance disorder caused by an abnormality found in a section of the inner ear called the labyrinth.

There are an estimated 3 to 5 million people in the US who have Meniere's disease, with 100,000 new cases diagnosed each year.

What causes Meniere's disease?

The labyrinth has two parts:

• bony labyrinth
• membranous labyrinth

The membranous labyrinth is encased in bone and contains a fluid called endolymph.

When the head moves, the endolymph also moves, which causes nerve receptors in the membranous labyrinth to signal the brain about the body's motion.

When, for some reason, the endolymph increases, the membranous labyrinth balloons or dilates (a condition called endolymphatic hydrops).
If the membranous labyrinth ruptures, the endolymph mixes with another inner ear fluid called perilymph.

The mixing of the two fluids is believed to cause the symptoms of Meniere's disease.

What are the symptoms of Meniere's disease?

The following are the most common symptoms for Meniere's disease, however, individuals may experience symptoms differently. Symptoms can occur suddenly, or may happen daily or infrequently.

Balance

The vestibular system:

     • controls balance
     • controls posture
     • regulates locomotion and other        movements
     • provides conscious        awareness of orientation in        space
     • provides conscious        awareness of visual fixation in        motion

Balance can be impaired by:

     • disease
     • altered gravity
     • aging
     • exposure to unusual motion

When balance is impaired, normal movement is affected, as well as motivation, concentration, and memory.

An estimated 2 million adults suffer from chronic dizziness or difficulty with balance. It particularly affects people aged 65 or older.

The most debilitating symptom is vertigo, which can cause the patient to have to lie down, as well as:

      • severe nausea
      • vomiting
      • sweating

Other symptoms may include:

      • tinnitus
      • loss of hearing
      • pressure in the affected ear
      • loss of balance
      • headaches
      • abdominal discomfort
      • diarrhea

The symptoms of Meniere's disease may resemble other conditions or medical problems. Consult a physician for a diagnosis.

Diagnosis of Meniere's disease:

In addition to a complete medical history and physical examination, the physician may request:

      • hearing test
      • balance test
      • magnetic resonance imaging (MRI) scans to determine if tumor is present
      • electrocochleography to measure electrical activity of the inner ear

Treatment for Meniere's disease:

Specific treatment will be determined by the physician(s) based on:

      • patient's age, overall health, and medical history
      • extent of the disease
      • expectations for the course of the disease
      • patient's tolerance for specific medications, procedures, or therapies
      • patient's (or family's) opinion or preference

Treatment may include:

      • surgery
        Several types of surgery are effective for treating the balance problems of Meniere's disease. The most common         surgical treatment is the insertion of a shunt (silicone tube) to drain of excess fluid.
      • medication
        Medications may be given to control allergies, reduce fluid retention, or improve the blood circulation in the inner         ear.
      • change in diet
        Eliminating caffeine, alcohol, and salt may reduce the frequency and intensity of symptoms.
      • behavior therapies
        Reducing stress may lessen the severity of the disease symptoms.