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Meniere's Disease

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by Alan R
 

Definition

Meniere's disease is a disorder of the labyrinth in the inner ear that causes vertigo, tinnitus, 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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Diagnosis

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:
  • Blood tests
  • Hearing test
  • Electronystagmogram—looks for abnormal eye movements
  • Auditory brainstem response
  • Electrocochleogram—to check function of the hearing organ in the inner ear
  • MRI scan—to look at internal structures of the ear
 

Treatment

There is no cure for Meniere's disease. Treatment focuses on managing your symptoms. Talk with your doctor about the best treatment plan for you. Options may include one or more of the following:

Dietary and Lifestyle Changes

Dietary changes include:
Lifestyle changes include:
  • Bed-rest during acute attacks of vertigo
  • Promptly begin replacing fluids lost to heat or exercise
  • Minimize stress
  • Avoid medications 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

Vestibular Rehabilitation

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.

Therapy

Consider working with a therapist or joining a support group. These can help you to cope with your symptoms.

Medications

Your doctor may recommend:
  • Medications to treat vertigo
  • Antiemetics to control nausea
  • Medications that may improve hearing, control inner ear swelling, or limit overall symptoms, including:
    • Antihistamines
    • Diuretics
    • Antidepressants or anti-anxiety medications
    • Cortisone drugs for a short time
  • Aminoglycoside therapy to permanently destroy the part of the inner ear that deals with balance

Surgery

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, and 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
 

RESOURCES

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Meniere's.org
http://www.menieres.org

 

CANADIAN RESOURCES

Canadian Family Physician
http://www.cfpc.ca

Meniere's Disease
http://www.menieres-disease.ca

 

References


Meniere's disease. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/menieres-disease.html. Updated September 2010. Accessed September 17, 2013.


Meniere's disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated March 15, 2013. Accessed September 17, 2013.


Meniere's disease. National Institute of Deafness and Other Communication Disorders website. Available at: http://www.nidcd.nih.gov/health/balance/Pages/meniere.aspx. Updated July 2010. Accessed September 17, 2013.


12/3/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Hillier S, McDonnell M. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2010;(10):CD005397.

 

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