Menière’s Disease : What is it? What is it caused by? What is the cure?
By Prof. Eugenio Mira – Otorhinolaryngologist – Columbus Clinic Center
What is it?
It is a disorder of the labyrinth, or inner ear, that was first described in 1861 by the Parisian doctor, Prospero Meniere. It is characterised by episodes of vertigo and hearing difficulties in one ear. The episodes of vertigo can occur without warning. Symptoms are severe, and are accompanied by nausea and vomiting. The subject cannot stand upright or walk around. Episodes last from between 20 minutes to 6-7 hours, and further events can be unpredictable and after varying intervals of time. Hearing difficulties involve loss of hearing of different degrees (hypacusis), a buzzing noise in the ear (tinnitus), and a sensation of pressure, or fullness, in the ear. These symptoms come and go, and worsen during the episodes of vertigo. At an advanced stage, these episodes can occur more and more frequently, and are increasingly intense, leading to subjects constantly losing their balance. Moderate-severe hearing loss is established across all frequencies.
What is it caused by?
It is due to increases in pressure and in the amount of fluid (endolymph) contained in the spaces of the membranous labyrinth of the inner ear. These spaces then dilate, a phenomenon known as endolymphatic hydrops. There are many reasons for these increases in pressure, some of which are still not fully understood.
How is it diagnosed?
Diagnosis is reached by putting together the clinical history of the patient through an anlysis of medical records, and through audiometric and vestibular tests.
What is the cure?
With medical treatment (a low-salt diet and diuretics) and, in resistant cases, intratympanic injections (in the middle ear through the tympanic membrane) of cortisones and gentamicin. Particularly severe cases require surgical excision of the vestibular nerve (neurectomy).