Meniere disease is a chronic inner ear syndrome marked by attacks of vertigo, progressive deafness, tinnitus, and a sensation of fullness in the ears. The condition usually appears in persons between ages 40 and 50.
The cause of Meniere disease is not known, but the disease process appears to destroy the hair cells within the cochlea. Experts on Meniere disease think that a rupture of the membranous labyrinth allows the endolymph to mix with perilymph, causing the symptoms of Meniere disease. Scientists are investigating several possible causes, such as noise pollution and viral infections, as well as biological factors.
Signs and Symptoms
The classic symptoms are severe vertigo, tinnitus, and sensorineural hearing loss. An acute attack of vertigo may cause nausea, vomiting, sweating, and loss of balance. These attacks may occur several times a year, but remissions also can last several years.
When all three classic symptoms are present, the diagnosis is not difficult. Further testing using audiometry and radiographs of the internal meatus of the ear may be necessary. The primary care provider may request an MRI to rule out brain involvement. Accurate measurement and characterization of hearing loss are of critical importance in the diagnosis of Meniere disease.
There is no cure for Meniere disease. A salt-free diet, diuretics, antihistamines, and mild sedatives are helpful in long-term care. Changes in medications that either control allergies or improve blood circulation in the inner ear may help. Eliminating tobacco use and reducing stress levels are more ways some people can lessen the severity of their symptoms. If the disease persists and causes debilitating vertigo, surgical intervention may be necessary. Labyrinthectomy (removal of the inner ear sense organ) can effectively control vertigo but sacrifices hearing. Vestibular neurectomy, selectively severing a nerve from the affected inner ear organ, usually controls the vertigo and preserves hearing but carries surgical risks. Recently, the administration of the ototoxic antibiotic gentamicin directly into the middle ear space has gained popularity worldwide for the control of the vertigo of Meniere disease.
No significant complementary therapy is indicated.
Instruct clients on what foods are low in sodium, with a dietary goal of fewer than 2000 mg per day. Be sure clients are aware of side effects of any prescribed medication.
The prognosis varies, but usually recurrent attacks over several years lead to residual tinnitus and hearing loss.
There is no known prevention for Meniere disease.