Meniere’s disease is a rare condition that impairs the functioning of the inner ear. The inner ear, also known as auris interna or the labyrinth of the ear, performs the crucial roles of facilitating auditory responses upon processing sound waves from various sources, thereby enabling the sense of hearing. It is also responsible for maintaining balance, stability across the human system. When the operations of the inner ear are hampered like in Meniere’s disease, it triggers dizzy sensations, vertigo, constant ringing in the ears and even partial hearing loss.
This ailment usually occurs in people over the age of 40, afflicting both men and women alike and initially arises in one ear, eventually affecting both ears. Meniere’s disease is designated after the renowned French physician, Prosper Meniere, who was the first to describe the characteristic signs of the illness in 1861. Although Meniere’s disease is a chronic disorder prompting a decline in the body’s ability to retain balance and one that has no cure, the uneasy symptoms can be managed with proper medical treatment measures.
Causes Of Meniere’s Disease:
The discomforting indications associated with Meniere’s disease stem from the accumulation of a fluid – endolymph, in the inner ear, which blocks the tubular drainage pathways and thus hinders its operations of enabling hearing and balance.
The reasons that trigger excess fluid secretions in the inner ear are postulated to be infection most probably from a virus, an aberrant response of the immune system or even due to genetic defects. However, the precise cause of Meniere’s disease and why this fluid surplus occurs in the inner ear is not known.
The characteristic signs of Meniere’s disease take place at varying intervals of time, in the form of attacks or episodes and comprise:
- A feeling of fullness in the ears
- Partial hearing loss, eventually becoming permanent in old age
- Vertigo or dizziness every 24 hours
- Uncontrolled sweating
- Difficulty positioning the body steadily with loss of stability, balance
- Relentless headaches
- Nausea and vomiting
- Ringing sensation in the ears i.e. tinnitus
Owing to erratic instances of vertigo and fainting, the risk of developing serious injuries from falls and accidents is quite high in individuals with Meniere’s disease. This inner ear defect also induces massive mental stress and physical exhaustion from continuously attempting to control dizzy spells, thereby hampering productivity throughout the day.
A major consequence of Meniere’s disease is complete hearing loss with increasing age.
The physician initially does a thorough physical exam and also records the complete family history and personal medical history of the patient. Upon assessing the frequency of symptoms such as vertigo, hearing loss and tinnitus, the doctor performs a hearing test or audiometry to gauge the ability to hear sounds at differing volumes, pitches and of various types.
In addition to hearing analysis, the healthcare provider also studies the bodily balance and stability of the patient by means of the following protocols which examine the functioning of the inner ear:
- Videonystagmography (VNG)
- Electrocochleography (ECoG)
- Rotary-Chair Testing
- Video Head Impulse Test (vHIT)
- Vestibular Evoked Myogenic Potentials (VEMP) Testing
Currently, no cure is available for Meniere’s disease and it is a life-long condition that affects the inner ear functions. Nevertheless, numerous treatment measures help to keep the persistent symptoms in check and lower the severity of the bouts of vertigo.
In minor cases of Meniere’s disease, the medical professional prescribes motion sickness and anti-nausea medications to manage the indications of dizziness and vomiting. To decrease the accruing of fluids in the inner ear, the doctor also prescribes diuretic medicines to lower fluid retention in the body and advises the patient to cut down on salt consumption. Vestibular rehabilitation and positive pressure therapy are given to ensure the stability of the body and reduce the volume of fluid in the inner ear. Hearing aids are also recommended to affected persons, to help with better auditory functions.
In more severe cases of Meniere’s disease or if the above non-invasive techniques do not alleviate symptoms, then the doctor administers middle ear injections filled with medicated fluids which are assimilated by the inner ear, thereby relieving vertigo and tinnitus.
Very grave occurrences of Meniere’s disease which impede the ability to carry out regular routines and normal day-to-day activities are treated with surgery of the inner ear, entailing procedures such as:
- Endolymphatic Sac Procedure
- Vestibular Nerve Section