Meniere’s disease is a rare condition that affects the inner ear. It is marked by recurring vertigo, hearing loss, and tinnitus, and it may happen because of excess fluid buildup inside the ear canals.
Also known as Meniere’s syndrome, Meniere’s disease can affect one or both ears. It can occur at any age, although it is more common in people between ages 20 and 50.
Meniere’s disease has no cure. However, treatments recommended by an otolaryngologist, such as diuretics, a low-sodium diet, and physical therapy, can help control symptoms and prevent attacks.
Symptoms of Meniere’s disease
The main symptoms of Meniere’s disease are:
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Vertigo;
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Dizziness;
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Loss of balance;
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Tinnitus;
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Reduced or lost hearing;
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Feeling of a blocked ear.
Symptoms of Meniere’s disease may start suddenly, last for a few minutes or hours, and vary in how intense and frequent the attacks are.
Confirming a diagnosis
Meniere’s disease is usually diagnosed by an otolaryngologist based on the person’s symptoms and health history.
To confirm the diagnosis, the doctor may order tests such as audiometry, videonystagmography, electrocochleography, magnetic resonance imaging, and laboratory tests.
Some criteria for diagnosing Meniere’s disease include having 2 episodes of vertigo that last at least 20 minutes and hearing loss confirmed with a hearing test.
Possible causes
The specific cause of Meniere’s disease is still unknown. However, it is believed to be related to excess fluid buildup inside the ear canals.
This fluid buildup in the ear canals may happen due to factors such as allergies, anatomical changes in the ear, infections, head injuries, frequent migraine, and an overactive immune system response.
Treatment optios
Treatments for Meniere’s disease include:
1. Medications
The medications recommended by the doctor to treat Meniere’s disease are:
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Diuretics, such as hydrochlorothiazide: recommended to reduce the frequency and intensity of vertigo attacks because they decrease fluid buildup in the ear canals;
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Anti-vertigo medications, such as meclizine: prescribed to help control and reduce symptoms of vertigo, nausea, tinnitus, and hearing loss;
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Antiemetics, such as meclizine, dimenhydrinate, and metoclopramide: recommended during attacks to relieve nausea and vertigo;
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Tranquilizers, such as lorazepam and diazepam: also used during attacks to reduce the feeling of dizziness and vertigo.
In addition, the doctor may also recommend other medications, such as vasodilators to improve local circulation, and corticosteroids or immunosuppressants to regulate immune activity in the ears.
2. Physical therapy
Physical therapy is very important for people with this disease and is known as vestibular rehabilitation therapy.
During physical therapy, the physical therapist recommends exercises that can help reduce dizziness and imbalance, improve sensitivity to movement, and provide safety recommendations the person can use during attacks.
3. Injections
Injections into the ear may be recommended when other treatments are not effective and include:
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Antibiotic injections, such as gentamicin: decrease the activity of the affected ear in balance control, transferring this function to the healthy ear;
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Corticosteroid injections, such as dexamethasone: dexamethasone is a corticosteroid that reduces inflammation in the ear, reducing the intensity of attacks.
This type of treatment can only be performed in the office of a doctor who specializes in treating conditions such as Meniere’s disease.
4. Surgery
Surgery is only recommended when other forms of treatment do not improve this disease and depends on the person’s symptoms.
Surgery may be done using endolymphatic sac decompression, a technique that decreases fluid production or increases fluid absorption.
Other surgeries that may also be recommended by the doctor include vestibular nerve section or labyrinthectomy, which is only performed when the person already has hearing loss.
5. Diet
It is important to follow a low-sodium diet to reduce fluid in the ear and help prevent attacks. Therefore, foods high in sodium should be avoided, such as ham, bologna, bacon, sausage, ready-made seasonings, and cheeses.
It is usually recommended to consume no more than 1.5 grams of salt per day, which is equal to approximately 3/4 of a teaspoon of salt.
In addition, it is also recommended to reduce the intake of alcoholic and caffeinated beverages and avoid smoking, as these can irritate the structures of the ear.