What is Meniere’s disease?
Meniere’s disease is a long-term, progressive illness that damages the organs of the inner ear responsible for hearing and balance.
Symptoms of Meniere’s disease:
- Long episodes of vertigo
- Hearing loss
- Loud tinnitus in the affected ear
In the early stages, hearing sensitivity may recover after each episode. As the disease progresses, hearing loss almost always reaches profound levels rendering the ear functionally deaf.
Who is most likely to get Meniere’s disease?
According to the Mayo Clinic, adults are most likely to get the disease.
- Young-to middle-aged adulthood (40s-50s)
- Peaks at about 60 years of age
- Appears to affect men and women* equally
Roughly 200/100,000 (0.2%) of people in the U.S. have Meniere’s disease. While the Framingham Heart Study found that 1.48% of the US population reports a history of Meniere’s disease, it’s largely agreed that the reason for this discrepancy likely due to the tendency of primary care physicians to diagnose all cases of recurrent episodic vertigo as Meniere’s without first having ruled out other possible causes.
What causes Meniere’s disease?
In short, no one knows. That said, several theories can explain how the disease progresses and why it occurs. Researchers are approaching the root of the issue.
What is known is there is a connection between Meniere’s disease and a condition called endolymphatic hydrops; a situation in which the fluids of the inner ear get out of balance during vertigo caused by Meniere’s. The fluid imbalance is thought to cause the sensation of pressure in the ear and contributes to vertigo, tinnitus, and hearing loss.
Medical researchers at the University of Colorado believe this fluid imbalance reveals a pressure-regulation problem that decreases blood flow to the organs of the inner ear. In a young, healthy person, the blood flow is not completely interrupted because the vasculature in the ear, head, and neck are all intact. However, in older individuals with assumed vascular issues, the interruption in blood flow can be so complete that it causes a mini-stroke (similar to a transient ischemic attack, or TIA) in the inner ear.
Re-oxygenation and recovery after this event are less successful each time, explaining the decline of function in the affected ear as the disease progresses.
How is Meniere’s disease diagnosed?
Most clinics in Canada and the US use the following criteria:
- Two episodes of vertigo, each lasting 20 minutes or longer but not longer
than 12 hours
- Hearing loss verified by a hearing test
- Tinnitus or a feeling of fullness in the affected ear
- Exclusion of other known causes of these problems
Diagnostic procedures may include:
- Thorough case history
- Hearing assessment
- Medical imaging to rule out other condition
- A balance assessment
Treatment of Meniere’s disease
There is no true ‘cure’ for Meniere’s disease. However, physicians, otolaryngologists (ear, nose, and throat doctor), Audiologists, and other health professionals on the care team have several tools available to them to help manage the symptoms of Meniere’s disease.
Different professionals may recommend the following treatments:
Primary care physicians
- Motion sickness medications: reduce the spinning sensation and alleviate associated anxiety.
- Anti-nausea medications: control nausea and vomiting during an episode of vertigo.
- Fluid regulation medications: help manage the buildup of fluid in the inner ear. This may include a recommendation for a low salt diet.
Ear, Nose, Throat specialists
Managing: dizziness/vertigo, or preventing these symptoms from recurring
- Middle Ear Injections, of steroids or ototoxic (toxic to the ear) antibiotics to reduce the incorrect balance messages from the inner ear so that the other ear can compensate.
- Surgery, to decompress or even add shunts to the organs of the inner ear responsible for our sense of balance to help with fluid balance. Removal of the hearing and balance organs in a late-stage Meniere’s ear that has already lost all of its hearing ability or cutting through the vestibular nerve to preserve hearing in an affected ear are also possibilities.
Managing: the functional aspects of hearing
- Hearing aids to manage the consequent hearing loss and preserve communicative function.
- A hearing aid CROS system to provide stereo sound awareness if one of the ears is functionally deaf.
Other complementary treatments may include:
- Vestibular rehabilitation: typically provided by physiotherapists, occupational therapists, kinesiologists, or registered athletic therapists.
- Vestibular acupuncture: provided by acupuncturists.
If you are experiencing balance and hearing issues come and see us. Our Audiologists can evaluate and diagnose balance-related diseases and help you deal with the hearing loss associated with Meniere’s. While there isn’t a cure, treatment can reduce the frequency and severity of the vertigo.
Book online or call to schedule an appointment at the Broadmead Hearing Clinic: 250.479.2969 or Oak Bay Hearing Clinic: 250.479.2921.
*Harris, J. P. and T. H. Alexander (2010). "Current-day prevalence of Meniere's syndrome." Audiol Neurootol 15(5): 318-322.