Causative and risk factors
The exact cause of Meniere’s disease is not known. Excess secretion of the fluid from the ear or blockage of the drainage of fluid can cause Meniere’s disease.
It can be triggered by upper respiratory tract infections, middle ear infection, head trauma, migraines, atherosclerosis or obstructive sleep apnea. Smoking and consumption of alcohol can also trigger Meniere’s disease.
Clinical presentation
Meniere’s disease gives rise to vertigo lasting from few minutes to even 24 hours. There is loss of hearing in the affected ear. The patient experiences tinnitus or ringing sound in ear. There may be sensation of fullness in the affected ear. Other symptoms include headache, nausea and vomiting.
Investigations
There is no standard test to diagnose meniere’s disease. Diagnosis is made by excluding other causes of your symptoms. For this your doctor will enquire into your present and past medical history, do physical examination and order investigations. Investigations include audiometry, electrocochleography and electronystagmography.
Additionally your doctor may order imaging tests such as CT or MRI scan of the brain to rule out other conditions.
Treatment
Treatment for meniere’s disease includes medications and surgery. Medications include the use of diuretic and anti-emetic drugs. Injections of antibiotics or steroids can be given in the affected ear.
Vestibular rehabilitation therapy is suggested to the patient. Hearing aids may be used.
Any of the following surgical procedures may be advocated:
Endolymphatic sac procedure – to decrease fluid production or increase fluid absorption in the inner ear.
Vestibular nerve section – cutting the nerve that transmits balance and movement sensors from inner ear to the brain.
Labyrinthectomy – The portion of inner ear that controls balance is removed.
