Definition
Meniere disease is a disorder of the inner ear. It results in repeat attacks of vertigo and problems hearing.
| The Inner Ear |
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Causes
The exact cause is not known. It is thought to be caused by many factors, such as:
- A buildup of fluid in the part of the inner ear known as the labyrinth
- Genetics
- Problems with the immune system
- Infection
- Trauma
Risk Factors
This problem is more common in people who are 30 to 60 years of age. Other things that may raise the risk are:
- Having other family members who have this health problem
- Pressure changes in the atmosphere
- Allergies
- Stress
- Changes in hormones
- Problems sleeping
- Dietary changes, such as an increase in salt, caffeine, or alcohol
- Excessive sweating followed by a sudden increase in fluids
Symptoms
Problems may come and go. They may also be in one or both ears. A person may have:
- A sensation of spinning while standing still
- Balance problems
- Nausea and vomiting
- A feeling of fullness or pressure in the ear
- Ringing in the ear(s)
- Problems hearing
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the ears. You may need to see a doctor who treats ears.
A hearing test will be done.
- MRI scan —to look at internal structures of the ear
- Electrocochleogram—to check function of the hearing organ in the inner ear
- Vestibular evoked myogenic potential test—to check muscle activity in response to sound
- Caloric testing—to check for nerve damage
- Glycerol dehydration test—to see whether hearing improves after using a dehydrating agent
Treatment
There is no cure. The goal of treatment is to manage symptoms. Choices are:
-
Medicines to:
- Ease vertigo
- Control nausea
- Reduce fluid buildup
- Dietary changes, such as limiting salt, caffeine, and alcohol
- Lifestyle changes, such as reducing stress and safety measures to avoid falling
- Physical therapy to learn vestibular exercises to get the body used to moving without vertigo
- A Meniett device that gives low-pressure pulses to the middle ear
- A counselor or support group to learn how to cope with symptoms
People who are not helped by these methods may need surgery, such as:
- Endolymphatic sac decompression to remove of a portion of inner ear bone and place a tube in the inner ear to drain excess fluid
- Labyrinthectomy to destroy or remove the entire inner ear
- Vestibular nerve section to cut the nerve in the ear that controls balance
RESOURCES
American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
Meniere's http://www.menieres.org
CANADIAN RESOURCES
The College of Family Physicians of Canada http://www.cfpc.ca
Meniere's Disease http://www.menieres-disease.ca
References
Lopez-Escamez JA, Carey J, et al.; Classification Committee of the Barany Society, Japan Society for Equilibrium Research, European Academy of Otology and Neurotology (EAONO), Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), Korean Balance Society. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7.
Meniere disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/meniere-disease. Accessed March 24, 2021.
Meniere's disease. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/menieres-disease. Accessed March 24, 2021.
Meniere's disease. National Institute of Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/menieres-disease. Accessed March 24, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board Daniel A. Ostrovsky, MD
- Review Date: 12/2020
- Update Date: 00/32/2021