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Meniere’s disease: Treatment, symptoms, advice and help

About Meniere’s disease

Meniere’s disease is a disorder of the inner ear which is responsible for hearing and maintaining the equilibrium of the body. It is characterized by episodes of giddiness and ringing in ears and progressive hearing loss. It may affect one or both ears. It may range in intensity from mild annoyance to a chronic, life-long disability.

Meniere’s disease: Incidence, age and sex

Meniere’s disease typically occurs between the ages of 30-60 and affects men slightly more than women.

Signs and symptoms of Meniere’s disease: Diagnosis

The symptoms of Meniere’s disease include periodic episodes of giddiness (vertigo) and fluctuating, progressive hearing loss in one or both ears. Ringing in ears (tinnitus) and a sensation of fullness in one or both ears are also seen. There is an increased prevalence of migraine (headache) in patients with Meniere’s disease. Patients may also experience unusual sensitivity to noises.

A detailed medical history and a comprehensive ENT (ear, nose and throat) examination may help in detecting the condition. Audiometry tests may be done to confirm conductive hearing loss. Imaging diagnostics like CT scan or MRI may be advised to rule out any other pathological causes.

Causes and prevention of Meniere’s disease

Meniere’s disease is believed to be related to excess fluid collection in inner ear. The symptoms may occur in the presence of a middle ear infection, head trauma or an upper respiratory tract infection. Consumption of aspirin, tobacco or drinking alcohol may also contribute to it. It has also been proposed that Meniere’s disease in many patients occur due to the deleterious effects of herpes virus infection.

Several environmental and dietary changes have been proposed to reduce the intensity and severity of the symptoms. Patients are advised low sodium diet (salt restriction to 1 -2 gram per day) and to avoid smoking, alcohol, tobacco and coffee. Patients are often prescribed a mild diuretic. As allergies have been shown to aggravate Meniere’s symptoms, such patients are candidates for allergy desensitization.

Meniere’s disease: Complications

Hearing loss on the affected side and inability to walk and carry out daily activities due to uncontrollable vertigo are some known complications.

Meniere’s disease: Treatment

The treatment of Meniere’s disease includes oral medications, ear devices and surgical approach. Medications like antihistaminics, anticholinergics, steroids and diuretics may be prescribed, which aim at lowering pressure within the inner ear. There are certain devices that provide trans-tympanic micro-pressure pulses (such as the Meniett) which are useful in reducing frequency of vertigo. The anti-viral drug acyclovir has proved beneficial in treating Meniere’s disease in some patients.

Surgery is considered in patients who do not respond well to medical treatment. These surgical methods include labyrinthectomy (removal of the inner ear), chemical labyrinthectomy (injecting an antimicrobial agent named gentamicin into the middle ear to kill the vestibular apparatus) and vestibular neurectomy (cutting the nerve to the balance portion of the inner ear).