Meniere disease is a disorder of the labyrinth in the inner ear that causes vertigo, tinnitus (ringing in the ears), and hearing problems. The labyrinth is a system of cavities and canals in the inner ear that affects hearing, balance, and eye movement.
|The Inner Ear|
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The cause of Meniere disease is unknown, but it is thought to be a combination of factors. Possible causes include:
- Rupture in part of the labyrinth, which allows fluid in different compartments to mix
- Scar tissue, which may cause a blockage in the labyrinth and buildup of fluid
- Inner ear injury
Meniere disease is more common in adults aged 30 to 60 years. Other factors that may increase your chance of Meniere disease include:
- Family history
- Viral infection
- Autoimmune disorders
- Barometric pressure change
- Hormonal disorders
- Excess salt in the diet
Meniere disease may cause fluctuating symptoms, which may come on suddenly. They typically involve only one ear, but may involve both. Symptoms include:
vertigo, a spinning sensation while standing still. Episodes may last 20 minutes to 3 hours. Vertigo may be accompanied by:
- Nausea or vomiting
- Paleness of the skin
- Weakness or falling
- In some cases, headache or diarrhea
- Fluctuating hearing loss
- Ringing in 1 or both ears—tinnitus
- Feeling of fullness or pressure in the ear
- Poor sense of balance
- A tendency for symptoms to worsen with movement
The doctor will ask about your symptoms and medical history. A physical exam will be done. This will include an examination of your ears and a neurologic exam to evaluate for possible nerve damage.
Tests may include:
There is no cure for Meniere disease. Treatment focuses on managing your symptoms. Talk with your doctor about the best treatment plan for you. Options may include 1 or more of the following:
Dietary and Lifestyle Changes
Dietary changes include:
- Avoid foods that are high in salt
- Avoid caffeine
- Drink adequate fluids
- Reduce alcohol intake
Lifestyle changes include:
- Bed rest during acute attacks of vertigo
- Promptly begin replacing fluids lost to heat or exercise
- Minimize stress
- Avoid medicines that seem to bring on or worsen symptoms
- Consider a hearing aid, if necessary
- Consider masking devices (white noise) to limit the effects of tinnitus
- If you smoke, talk to your doctor about how you can quit
- Take safety measures to avoid falling
Your doctor may suggest specific vestibular exercises. These exercises use a series of eye, head, and body movements to get the body used to moving without dizziness. You may work with a physical therapist to learn these.
Consider working with a therapist or joining a support group. These can help you to cope with your symptoms.
Your doctor may recommend:
- Medicines to treat vertigo
- Antiemetics to control nausea
Medicines that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
- Antidepressants or antianxiety medicines
- Cortisone drugs for a short time
- Aminoglycoside injected into middle ear
- Destroys the part of the inner ear that deals with balance
- May increase hearing loss
Ask your doctor if a Meniett device would be helpful to you. This device provides low-pressure pulses to the middle ear.
Surgical procedures are not always helpful, but include:
- Endolymphatic sac decompression—removal of a portion of inner ear bone and placing a tube in the inner ear to drain excess fluid
- Labyrinthectomy—destruction or removal of the entire inner ear, which controls balance and hearing
- Vestibular nerve section
There are no current guidelines to prevent Meniere disease. However, to help reduce your risk, avoid:
- High-salt diets
- Excess alcohol
- Avoid medicines that can be toxic to the ear
American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
The College of Family Physicians of Canada http://www.cfpc.ca
Meniere's Disease http://www.menieres-disease.ca
Meniere disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/meniere-disease . Updated December 5, 2016. Accessed August 22, 2017.
Meniere's disease. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/menieres-disease. Updated March 2014. Accessed August 22, 2017.
Meniere's disease. National Institute of Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/menieres-disease. Updated February 13, 2017. Accessed August 22, 2017.
12/3/2010 DynaMed Systematic Literature Surveillance https://www.dynamed.com/condition/meniere-disease : Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 09/2018
- Update Date: 07/15/2020