by EBSCO Medical Review Board

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

Prevention

There are no known guidelines to prevent this health problem.

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.

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