Ménière’s Disease

Ménière’s disease is a chronic inner ear disorder that affects balance and hearing. It usually impacts one ear and can cause sudden attacks of vertigo, tinnitus, fluctuating hearing loss, and a feeling of fullness in the ear. The condition is named after the French physician Prosper Ménière, who first described it in 1861.

Symptoms of Ménière’s Disease

The symptoms of Ménière’s disease usually occur in episodes, which can be unpredictable. These episodes can last from 20 minutes to several hours, with varying severity.

a. Vertigo (Severe Dizziness)

• The most disabling symptom of Ménière’s disease.
• Causes a sensation of spinning, making it difficult to stand or walk.
• May be accompanied by nausea, vomiting, sweating, and imbalance.
• Episodes can last anywhere from a few minutes to several hours.
• During a severe attack, a person may need to lie down until the vertigo subsides.

b. Tinnitus (Ringing or Buzzing in the Ear)

• A continuous or intermittent noise in the affected ear.
• Can sound like ringing, buzzing, roaring, or hissing.
• The intensity may increase before or during an episode.
• May cause sleep disturbances and difficulty concentrating.

c. Hearing Loss

• Often fluctuates in the early stages but may become permanent over time.
• Typically affects one ear but, in rare cases, both ears can be involved.
• People may have trouble hearing low-frequency sounds, such as deep voices or bass tones.
• Sounds may seem distorted or muffled.

d. Ear Fullness or Pressure

• A sensation of congestion or fullness in the affected ear.
• May feel like there is fluid trapped inside the ear.
• Can come and go but often worsens before an episode.

Causes of Ménière’s Disease

The exact cause of Ménière’s disease is unknown, but it is believed to be related to excessive fluid buildup (endolymph) in the inner ear. Several factors may contribute to this condition:

a. Abnormal Fluid Drainage

• The inner ear contains fluid that helps regulate balance and hearing.
• If this fluid does not drain properly due to a blockage or abnormal circulation, it may build up and cause Ménière’s disease.

b. Viral Infections

• Some studies suggest that viral infections, such as herpes or respiratory infections, may trigger inner ear inflammation and Ménière’s disease.

c. Autoimmune Disorders

• Some researchers believe that Ménière’s disease may be linked to the immune system attacking inner ear tissues.

d. Genetic Factors

• Ménière’s disease may run in families, suggesting a possible genetic component.

Diagnosis of Ménière’s Disease

There is no single test to diagnose Ménière’s disease. A doctor will assess a patient's medical history, symptoms, and conduct various tests, including:

a. Hearing Tests (Audiometry)

• Measures how well a person can hear different frequencies.
• Helps detect hearing loss associated with Ménière’s disease.

b. Balance Tests (Vestibular Tests)

• Examines inner ear function and balance control.
• Tests like videonystagmography (VNG) track eye movements to evaluate balance.

c. Imaging Tests (MRI or CT Scan)

• Used to rule out other conditions, such as acoustic neuroma (a benign tumor that affects hearing).

d. Electrocochleography (ECoG)

• Measures electrical activity in the inner ear.
• Helps detect fluid buildup in the cochlea.

Treatment of Ménière’s Disease

Ménière’s disease has no cure, but various treatments can help manage symptoms and reduce the frequency and severity of attacks.

a. Medications

• Motion sickness drugs (Meclizine, Dimenhydrinate): Help control vertigo and nausea.
• Anti-nausea medications (Promethazine, Ondansetron): Reduce vomiting during an episode.
• Diuretics (Hydrochlorothiazide): Help reduce fluid buildup in the inner ear.
• Corticosteroids: Reduce inner ear inflammation.

b. Lifestyle and Dietary Changes

• Low-Sodium Diet: Helps regulate fluid balance and prevent inner ear swelling.
• Avoid Caffeine & Alcohol: Can worsen tinnitus and trigger episodes.
• Reduce Stress: Stress and anxiety can trigger attacks.
• Hydration: Drinking enough water helps maintain fluid balance.

c. Physical Therapy (Vestibular Rehabilitation)

• Helps retrain the brain to cope with balance issues.
• Beneficial for people with long-term dizziness.

d. Hearing Aids

• Can improve hearing and reduce the effects of tinnitus.
• Helps patients with permanent hearing loss.

e. Surgical Options (For Severe Cases)

• Endolymphatic Sac Decompression: Helps drain excess fluid from the inner ear.
• Labyrinthectomy: Removes the affected inner ear (used only if hearing is completely lost).
• Vestibular Nerve Section: A nerve is cut to stop vertigo signals while preserving hearing.

Conclusion

Ménière’s disease is a chronic condition that affects hearing and balance, leading to vertigo, tinnitus, and hearing loss. While there is no cure, medications, lifestyle changes, and in severe cases, surgery can help manage symptoms. If you suspect you have Ménière’s disease, it is important to see a doctor for proper evaluation and treatment.