Meniere’s Disease is an inner ear disorder that is caused by an excessive amount of fluid build-up in the inner ear. The abnormal levels of fluid inside the inner ear impede the natural functioning of the inner ear. Since the inner ear’s primary function is to maintain the body’s balance & contribute to hearing, Meniere’s Disease leads to problems with balance & sensations of spinning pr moving out of control.
Meniere’s Disease also leads to problems with hearing & a ringing sound in the ears, also called tinnitus. People usually experience Meniere’s Disease in just one ear. Although it can happen at any age, Meniere’s Disease is generally diagnosed in people in their 40s to 50s. Meniere’s Disease is chronic, although with some treatments for Meniere’s Disease & certain lifestyle changes, the incidence of Meniere’s Disease can be cured.
For most people diagnosed with Meniere’s Disease, the prognosis is good for remission a few years after their diagnosis & the beginning of treatment.
Meniere’s Disease causes:
Although the exact causes of Meniere’s Disease are not known to doctors, it is believed that it’s caused by changes in the level of fluid in tubes of the inner ear. Other possible causes include autoimmune diseases, allergies, viral infections, inner ear infections, & genetics.
Meniere’s Disease symptoms:
Meniere’s Disease symptoms often come in the form of ‘episodes or ‘attacks’. Some of the most common Meniere’s Disease symptoms include:
- Vertigo, which can last anywhere between a few minutes to a full 24 hours
- A partial or complete loss of hearing in the affected ear
- Tinnitus, or a ringing sensation in the affected ear
- A feeling of fullness or pressure in the affected ear, also described as aural fullness or a sort of ‘plugged’ feeling
- Loss of balance
- Nausea, vomiting, & sweating which is usually caused by severe vertigo during these episodes
People with Meniere’s Disease often follow at least two to three of the symptoms mentioned below during a single episode:
- Hearing loss
- A feeling of fullness or pressure in the affected ear
In most people, there are no symptoms between two episodes or attacks of Meniere’s Disease. This can cause Meniere’s Disease to be mistaken for any other diagnosis which also causes similar symptoms, like labyrinthitis or Vestibular Neuritis.
Diagnosis of Meniere’s Disease:
Your doctor will order a few tests on you to figure out if you’re suffering from Meniere’s Disease, & to rule out any other causes of your symptoms. These tests include:
A hearing test, also known as an audiometry test, is used to test hearing loss in a patient. In this test, your doctor will make you wear headphones & play sounds of different pitches & volumes. The doctor will ask you to tell them when you hear a certain sound so that they can determine the range & extent of your hearing loss if any. This test also determines if you can differentiate between similar sounds. To test this ability, you will put on headphones through which you’ll hear some words. You will then repeat the same words to your doctor, which will let them know if your hearing loss is limited to one ear or is in both ears.
Sometimes, an issue in the inner ear or a problem with the inner ear nerve can also cause hearing loss. If your doctor suspects an inner ear problem behind your hearing loss, they might give you an electrocochleography test. This test checks the levels of electrical activity in your inner ear. Along with the electrocochleography test, an auditory brain response (ABR) test checks the function of the hearing nerves & the hearing centre of your brain. Both of these tests help your doctor understand if your hearing loss is due to your inner ear or the ear nerve.
Balance tests, like the Electronystagmography test (ENG test), are used to test the function of your inner ear. People with Meniere’s Disease often have a reduced balance response in the affected ear. The ENG test is used to measure the balance response in your inner ear. In this test, you’ll have electrodes placed around both the sides of your head where they detect eye movement in response to the balance reflexes from your inner ear. Cold & hot water/air will be passed into your ear alternatively to stimulate the balance system in your inner ear. While all this is happening, the doctor will note down the results of your eye movements as recorded by the electrodes placed around your head. Any abnormalities in eye movement will indicate a problem with the inner ear & how it perceives external stimuli related to balance.
Rotary Chair testing:
Rotary Chair testing is used less often than the ENG test, & even then in conjunction with the former. ENG testing can sometimes be unreliable if the person’s ears are clogged by ear wax or if they have ear damage. Rotary Chair testing is used to test if the problems in hearing & balance are due to an issue with the inner ear or the brain. In this test, your doctor records your eye movements while you sit on a rotating chair.
Vestibular Evoked Myogenic Potential (VEMP):
VEMP testing is used to measure the sound sensitivity of the vestibule in your inner ear.
Posturography testing is used to figure out which part of your balance system isn’t functioning properly. In addition to these tests, your doctor may also recommend head CT scans & MRI scans to figure out if any issues with your brain like a tumour, or a central nervous system issue like Multiple Sclerosis(MS), is causing your hearing issues.
Treatment for Meniere’s Disease:
There are many different treatments for Meniere’s Disease. Some of these include:
Your doctor may prescribe certain medications to help with the symptoms of Meniere’s Disease. These can include medicines for motion sickness, medicines for vertigo, & anti-emetics or anti-nausea medicines for nausea & vomiting.
Since Meniere’s Disease is caused by an excessive amount of fluid build-up in the inner ear, your doctor may also prescribe you water pills, or diuretics to help control the level of fluid in your inner ear. Usually, this also helps relieve tinnitus symptoms & thus acts as a tinnitus treatment as well.
In certain severe cases, your doctor might inject the medications directly into your inner ear through your middle ear to quickly provide relief to you.
Meniere’s Disease treatment exercises:
Meniere’s Disease treatment exercises help patients regain their sense of balance. These exercises are often recommended as a part of your vestibular rehabilitation therapy plan. VRT is a set of exercises designed to help your body compensate for the losses in your natural vestibular system by training your other senses to act in place of it.
In some cases, hearing aids can help a person regain their hearing & help resolve tinnitus symptoms. Hearing Aids might not cure Meniere’s Disease, but provide the patient with a way to enjoy the joys of hearing again.
Although surgery isn’t usually required for most cases of Menieres Disease, in some cases, your doctor might recommend it as a sort of last resort when all other treatment options fail. The surgical procedure, also known as the endolymphatic sac procedure, is done to decrease the production of excess fluid & increase the drainage of the existing fluid from the inner ear.
In addition to the above-mentioned treatment methods, patients can also try reducing their intake of salt, alcohol, caffeine, chocolate, & monosodium glutamate(MG) to help reduce their tinnitus symptoms & help with treatment for Menieres Disease.