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Meniere's Disease 101

Perhaps it is a disease you have never heard of. Or perhaps it is one that you know far too well. Ménière's Disease is a disease that affects the inner ear and vestibular system (balance). Named after French physician Prosper Ménière who first described the syndrome in 1861, this disease is more common then most are aware of.

According to the National Institute on Deafness and other Communication Disorders (NIDCD), based on recent research, it is estimated there are approximately 615,000 individuals with diagnosed Meniere's disease in the United States and 45,500 newly diagnosed cases each year.

What Is Meniere’s Disease?

Our hearing and balance systems are housed within what is called the labyrinth which has two parts: membranous and bony. The membranous portion of the labyrinth is necessary for hearing and balance and is filled with a fluid called endolymph. The movement of endolymph within the labyrinth is what is responsible for sending signals to the brain about the body’s movement and balance.

Health professionals believe an increase in the endolymph fluid has the potential to cause the labrynth to swell or dialate. This condition is referred to as endolymphatic hydrops and may very well play a part in symptoms of Meniere's disease.

Ménière’s experts believe endolymphatic hydrops may cause a rupture to occur in the membranous labyrinth and cause the endolymph fluid to mix with other inner ear fluids it is not supposed to mix with. This mixing of inner ear fluids is also thought to cause symptoms of Meniere's disease.

So although experts feel they have an idea of what contributes to Meniere's disease symptoms, they do not know exactly what causes the disease.

According to the NIDCD, ongoing research is investigating many possible causes such as environmental factors, such as noise pollution and viral infections, as well as biological factors.

Meniere’s Disease Symptoms

Persons who are diagnosed with Meniere's typically experience classic symptoms which may include:

  • Vertigo, which is a spinning type of dizziness can lead to inability to stand, sweating and vomiting
  • tinnitus, also known as ringing in the ears or hissing
  • hearing loss, which often fluctuates
  • a feeling of fullness or pressure in the affected ear

These symptoms occur with little to no warning. A Meniere's attack typically consists of ringing in the ears, vertigo and hearing loss. Most often the attack of these symptoms will last several hours. The level of severity and discomfort of the symptoms, and how often they occur varies individual to individual. There is no one predicting factor for often or severe a person will experience a Meniere's attack.

Human ear anatomy
The inner ear (purple) contains the hearing and balance organs. Photo courtesy Sonic Innovations

Meniere’s Disease Diagnosed

The diagnosis of Meniere's involves many different tests and can be a lengthy process if symptoms are not textbook.

Diagnosis will first begin with consulting a physician specializing in hearing and balance such as an otolaryngologist. After a medical history review and a physical exam, the physician will refer the patient for a full hearing evaluation by an audiologist and typically a magnetic resonance imaging (MRI).

Evaluating a potential hearing loss is an important factor in the Meniere's diagnosis. There are various hearing tests which allow the audiologist and physician to characterize the hearing loss and persons with Meniere's demonstrate common trends in their loss.

An audiologist may also perform and auditory brainstem response (ABR) test (electrical activity in the hearing nerve and brain stem) and electrocochleography (recording the electrical activity of the inner ear in response to sound) to assist in confirming the diagnosis.

Vestibular (balance) testing may also be performed if necessary.

Meniere’s Disease Treatment

Currently there is no cure for Meniere's disease.

Now the good news. Meniere's Disease symptoms can often be controlled once diagnosed. Let’s look at the symptoms and treatments you’d undergo.

The most successful way of controlling symptoms is by reducing the body’s retention of fluids through medication and/or changes in their diet. Examples of successful diet changes consist of low salt or salt free diets and no caffeine or alcohol.

For persons with more debilitating and severe Meniere's symptoms there are various surgical treatments that can be performed; however, these treatments most often result in a total loss of hearing and are reserved for persons who have already lost most of their hearing.

In regards to treating the hearing loss caused by Meniere's, digital hearing aids are often prescribed. Hearing loss from Meniere's does often fluctuate or can be permanent. Digital hearing aids allow the audiologist to adjust the level of amplification based on changes that may occur from time to time.

Living with Meniere's

The disease itself is no fun, but with ongoing research and medical treatments persons with Meniere's are finding success in managing their symptoms. And one day there may even be cure as researchers continue to learn more.

If you are experiencing Meniere's like symptoms, it does not necessarily mean you have Meniere's Disease; however, your hearing should be evaluated to determine what may be causing your symptoms.

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