What is Meniere’s Disease?
Meniere’s disease is a disease of the inner ear that can produce symptoms of vertigo or spinning, hearing loss, buzzing or ringing sounds and a sensation of the ear plugged up in the affected ear. While all symptoms may not be present, these episodes may occur randomly with vertigo typically lasting for more than 20 minutes to hours and associated with nausea or vomiting or headaches/migraine. Over time, the hearing loss gets worse. Sometimes both ears may be affected and the disease may run in families. In the early phases of the disease, the hearing loss tends to fluctuate. Classic Meniere's disease is defined as the complete presentation of the following symptoms:
Vertigo
Fluctuating hearing loss especially in the low frequencies
Tinnitus
Ear plugged-up sensation
Variations of the disease that affect only the hearing or balance areas are called cochlear or vestibular Meniere’s disease.
What Causes Meniere’s disease?
While the exact mechanism remains unclear, there are many causes that can result in Meniere's disease or endolymphatic hydrops which is a disorder of the inner ear. Some of these include:
Trauma to the ear
Viral infection
Autoimmune inflammation
Some sexually transmitted diseases
Allergies
The most common pathologic finding is of hydrops or excess liquid called endolymph in the balance and hearing organs of the inner ear.
How is Meniere's Disease Diagnosed?
An ear specialist or ENT such as Dr. Khetarpal will do an examination after thoroughly reviewing the patient's history. Often the history provides enough information for a diagnosis that is then confirmed by a hearing test, a balance test, and even an MRI scan that rules out a tumor in the hearing nerve. An allergy test may be performed if an association with allergies is noted on history. Autoimmune blood tests may be performed as well.
How is Meniere's Disease Treated?
The vertigo episodes are treated with medicines such as Meclizine to control the dizziness.
In addition to medication, a low-salt diet, caffeine-free diet, avoiding alcohol and chocolates, wine or cheese may help.
A diuretic or water pill may be prescribed.
Occasionally, valium or a sedative may be necessary.
One or more steroid injections to the ear may be an effective treatment and occasionally a gentamicin injection to the ear may be necessary.
Oral steroids can help in reducing inner ear inflammation or hydrops.
Sometimes an incision of the eardrum or tympanic membrane may be useful or even placing a tube in the eardrum.
Some advocate the use of a device called Meniett which delivers pulses of pressure to the inner ear via the tympanostomy tube.
If none of these measures work, surgery is the next step and a variety of surgical options are available, drugs such as Stugeron and Cinnarizine used in Europe are not available in the US
What Precautions Can I Take During an Episode?
Stay at home, DO NOT DRIVE OR OPERATE MACHINERY during an episode, take the vertigo pills or anti-nausea medication, and let the episode pass.
What Happens to My Hearing Loss?
Over time, the hearing loss generally worsens until the disease is burnt out. Hearing aids may be required to improve hearing.
Do your ears feel like they are plugged up and are you experiencing episodes of vertigo? Book an appointment immediately. Same day and next day appointments available!
Call (832) 990-2700 or click here to request an appointment online.
Dr. Khetarpal accepts most major insurance plans and is accepting new patients in The Woodlands and in The Heights. Make an appointment with one of Houston's leading ENTs.
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