Meniere’s disease affects the inner ear causing ear fullness, ringing and loss of hearing. There will be constant spinning motion inside the ears and pressure on the inner ear. The flow of fluids will not be at normal rate for the person affected with Meniere’s disease. Very often, it affects only one ear. Though this disease can develop on people of any age, it occurs largely on adults of 40-50 years. Medications are available for controlling the symptoms and many times diet and little changes in lifestyle can help you to overcome the symptoms. In rare cases, surgery is the option.
Vertigo Episodes :
There will be a sensation of spinning movement inside the ears. It is very much like the feeling you get when you stop suddenly after spinning for several times. It causes loss of balance and it occurs almost suddenly without any warning. This episode may last for few minutes or even hours. It can cause vomiting/nausea.
Hearing loss :
Loss of hearing is not certain in all the people affected with Meniere’s disease and it depends on the intensity of the disease. It can cause certain degree of hearing loss and for some it can be permanent.
It is a feeling of constant ringing sound in the ear and many people complain this as roaring sound or whistling sound inside the ears. In addition, there will be fullness feeling in the ear due to increased pressure caused by flow of fluids. First it starts with fullness feeling followed by tinnitus followed by vertigo. The entire episode may occur for 20-30 minutes or even more. Since there is variation in the duration of the episodes, it can cause mild to severe disturbance in hearing.
Exact cause of Meniere’s disease is not known. It is believed to develop due to excess flow of fluids in the inner ear. If you look into the inner ear, you can see a group of cavities and passages. The outer part of inner ear is made of bony labyrinth and inner portion is called as membrane labyrinth. This membrane portion contains endolymph (a special fluid) and has a lining of hairy structures which respond to fluid movements. For these sensors of hairy structures to function properly, the fluid should maintain constant volume and pressure. However if there is excess of fluid pressure it can lead to Meniere’s disease. Certain factors like migraine, abnormal immunity, improper fluid drainage and viral infection can affect the fluid quantity and pressure.
Based on the symptoms your doctor will refer the case to ENT specialist who will do hearing assessment. Audiometry test will be done for checking the functionality of the ears and how far you can hear different pitches. Quality of hearing can be assessed by this test and your doctor will also able to tell you if the problem is due to nerve of the inner ear or due to Meniere’s disease.
For testing the balance function, VNG videostagmography test is done during which warm/cool water or cool air is sent into the inner ear and subsequently your eye movements are recorded using special goggles. Any abnormality in this test is a clear sign of problem in the inner ear. Alternatively rotary chair test or VEMP test or posturography test is done for checking the inner ear function. Sometimes you will be asked to undergo various imaging tests like MRI or CT scan to rule out other problems in the brain.
There is no cure for Meniere’s disease but there are solutions for managing the symptoms. The condition of vertigo episodes can be controlled by medications like meclizine which would reduce the rotating sensation inside the inner ear. Drugs like promethazine are given to control nausea/vomiting sensation due to vertigo. Fluid retention is managed by several effective medications like Dyazide or Maxzide. It helps in reducing the body fluid which in turn would control the flow of fluid inside the ears. These drugs are effective diuretic. But you need to check for fluid balance regularly since it may cause depletion of some important minerals due to frequent urination.
Some kinds of non-invasive therapies like rehab therapy and hearing aid are effective in managing Meniere’s disease. Vestibular rehab therapy is ideal to attain the right balance easily. Your brain and body will effectively regain the balancing ability by practicing certain exercises. Hearing aid is recommended for restoring the loss of hearing. For some people, meniett device is used to apply pressure on the middle ear which can improve fluid transfer.
An injection like gentamicin is injected into the middle ear and for some people steroids like dexamethasone is given to reduce the vertigo episodes and to attain balance. Surgery is the last option for this disease and is done only if the symptoms are severe and other therapies are ineffective. Endolymphatic procedure or vestibular nerve procedure is done for decreasing the vertigo and for retaining fluid balance. For some people labryinthectomy is done during which the affected portion of the ear is removed and is done only if the patient has lost his hearing in that particular ear.
Lifestyle Changes :
You cannot solve the symptoms by home remedies but you can reduce its impact very well. If you are feeling dizzy due to vertigo episode you should sit down calmly when you get the first sign. Avoid seeing bright lights or watching television during that time. Take some rest after you have got an episode to restore your balance. Illuminate your house properly so that you may not fell down when you get up during nights. People having frequent vertigo should avoid driving motorcycle or car to prevent any accidental injury.
Adjust your eating pattern such that you are getting enough food/drinks throughout the day. You can opt for 5-6 small meals instead of 3 hefty meals. Reduce the salt intake to prevent fluid retention. You need to avoid taking coffee since it can make the ringing sound worse. Quit smoking and drinking and reduce your stress by joining yoga class. You can avoid allergy causing agents and stay away from them since it can aggravate the symptoms. The only worst part of Meniere’s disease is sudden episodes of vertigo and tinnutis. Under such circumstances the person should take break from his workplace to lie down quietly. He cannot have entertainment during such episodes. Some people can get depressed or feel anxious because of this episode and cannot take part in leisure activities.