Ménière's disease is a chronic disorder of the inner ear.
Ménière’s disease usually affects those between the ages of 20 and 50, with women experiencing higher incidences than men. Treatments are available to help reduce symptoms, but, if left untreated, permanent hearing loss and balance problems may occur.
Ménière’s disease can be extremely disruptive to daily life.
The exact cause has not been identified, but Ménière’s disease is associated with increased fluid pressure in the inner ear. An inner ear abnormality may be to blame.
Several risk factors have been linked with Ménière’s disease. Those who suffer from migraines, headaches, or motion sickness are at greater risk for developing the condition. A genetic component may place an individual at higher risk if family members have similar disorders.
Also, environmental triggers have been identified. A diet high in sodium, excessive caffeine intake, alcohol, and high stress levels have all been linked with Ménière’s disease.
Typically, only one ear is affected, although 15 percent of patients experience symptoms in both ears. Symptoms generally appear without warning and may last a few hours, up to a few days. These intermittent attacks vary in frequency; severe cases may face daily flare-ups, while others may go months, or even years between attacks.
Symptoms during an attack include:
A feeling of fullness or pressure in the inner ear
Constant ringing, buzzing, whistling, or roaring in the ear
Extreme vertigo (dizziness) or a spinning sensation (affects balance)
Temporary hearing loss
After an attack has resolved, individuals may continue to experience difficulty with balance, which may take days or weeks to improve. Each episode also damages the inner ear, leading to permanent deficits in hearing and balance.
Many patients (around 60 percent) stop experiencing Ménière’s disease attacks after a few years. Others may continue to have attacks. Severity may progress to the point that both ears are affected.
A detailed medical history and physical will help identify genetic or environmental risk factors, with special attention to family history, diet, and lifestyle.
Several diagnostic tests may be used to confirm Ménière’s disease. A standard hearing examination will be given to confirm type and degree of hearing loss. A variety of tests may be conducted to assess balance function. Electrocochleography is used to evaluate pressure in the inner ear.
Treatment is aimed at reducing distressing symptoms and improving quality of life. Treatments may include:
Dietary and lifestyle changes (no alcohol or caffeine, low-salt diet, stress reduction)
Medications to reduce inner ear pressure and vertigo
Minimally invasive treatments are implemented first. If diet and lifestyle changes are not effective, medications or more invasive treatments may be necessary.
Intratympanic injections, the newest form of treatment for patients with Ménière’s disease, involves the injection of a steroid behind the eardrum. Recent studies have reported that symptoms were significantly controlled in approximately 90 percent of patients who received the injections.
Surgery is considered only when other treatments have not been effective and the patient continues to have debilitating symptoms.