What is Ménière’s Disease?

Ménière’s disease is a rare disorder affecting the inner ear, which is the centre for hearing and balance. The symptoms of ménière’s disease are episodic (meaning that they come and go). During an attack, a patient may experience vertigo, hearing loss, tinnitus (ringing in the ear) and a feeling of pressure or fullness deep in the affected ear. The combination and frequency will vary from person to person, but attacks last for up to few hours at a time and can be worsened by stress and fatigue.

The onset of ménière’s disease typically occurs between the ages of 20 and 50 years. Only one ear is generally affected, though both ears may be affected in roughly 15 per cent of cases. After months or years of the disease, hearing loss can become permanent. The effects vary widely between each patient, which is why treatment will differ depending on the combination and severity of symptoms.

What Are The Symptoms?

The symptoms of ménière’s disease can include:

  • Vertigo
    Balance will be affected as the room will feel like it is spinning. Some people may experience motion sickness.
  • Hearing loss
    Patients may experience difficulty in distinguishing speech or the location of sound. They can also lose hearing of the lower frequencies resulting in a fuzzy, unclear sound.
  • Tinnitus
    Patients can often hear noises in the ear, which can be hissing, roaring or ringing sounds.
  • Fullness of the ear
    Patients may feel like the affected ear is under pressure – and sometimes even feel like it’s about to burst.
  • Noise sensitivity
    Some patients may find that certain sounds and pitches hurt the affected ear.

What Causes The Condition?

The cause of ménière’s disease is not known, but symptoms are caused by a build-up of fluid in the inner ear. Too much fluid may accumulate from excess production or inadequate drainage or absorption. This build-up interrupts the message to the brain from the nerves in the balance and hearing centres, and symptoms will follow.

Diagnosis

After the patient’s full history of symptoms has been taken, there are a series of diagnostic tests to check hearing and balance.

Patients undertake a hearing test, which will typically show a sensory type of hearing loss in the affected ear. Often, speech discrimination will be diminished in the affected ear, meaning that words like ‘sit’ and ‘fit’ will be difficult to tell apart.

An electronystagmogram (ENG) and rotational platform will test the patient’s balance. In roughly half of patients, balance is impaired in the affected ear.

Other tests can include:

  • Electrocochleography (ECoG) to test for increased inner ear fluid;
  • Auditory brainstem response (ABR) to test the hearing nerves and brain pathways; and
  • Magnetic resonance imaging (MRI) or computed tomography (CT) to rule out a tumour or other diseases that can mimic symptoms of ménière’s disease.

Treatment

There is no cure for ménière’s disease, but symptoms can be managed very effectively, with treatments including:

  • Medication to control the vertigo, reduce fluid retention and lessen anxiety;
  • Lifestyle changes such as stress management and a low-salt diet;
  • An air pressure pulse generator to relieve the build-up of pressure in the inner ear; or
  • Intratympanic injection with either gentamicin or dexamethasone to stop the signals being sent to the brain from the balance function of the inner ear.

Professor Marcus Atlas and the team at Ear Science Surgery are also experts in the surgical management of ménière’s disease.

Reference

Ménière’s Disease, American Academy of Otolaryngology-Head and Neck Surgery Patient Information

Ears – Ménière’s Disease, Victoria State Government Better Health

Ménière’s Disease - Related Content

Surgical Options for Ménière’s Disease

Ménière's disease is a debilitating condition. Some patients will not respond to medical treatment, in which case surgery will be considered as a last resort. If you are experiencing severe attacks of ménière's disease and previous treatments have not helped, you may be part of the 10-20 per cent of patients who are recommended for surgery.