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Meniere’s Disease

Meniere’s disease (MD) is an inner ear disorder characterized by episodic rotational vertigo lasting at least 20 minutes each (feeling like the world is spinning), tinnitus (ringing in the ears), fluctuating hearing loss, and a fullness in the ear. In most cases only one ear is involved, but both ears may also be affected. The initial triggers of Meniere’s disease are not fully understood. One popular theory is that Meniere’s disease appears to be the result of an excessive build-up amount of fluid (endolymph) in the vestibular system of the inner ear interfering with the normal balance and hearing signals between the inner ear and the brain.

Factors that affect the fluid, which might contribute to Meniere’s disease, include genetic predisposition, viral infection, head trauma, abnormal immune response, etc.

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The vestibular labyrinth (indicated by the red circle) is essential to normal movement and equilibrium. Since it is close to cochlea (the hearing organ), abnormal amount of fluid (endolymph) in the vestibular system may mechanically and chemically interfere with the sensory cells for balance and hearing, not only causing vertigo, but also affecting hearing

Diagnosis of Meniere’s disease

The diagnosis of Meniere’s disease is primarily made from the history and physical examination. There are several different tests for a Meniere’s disease diagnosis. Since Meniere’s disease often causes a low pitch (low frequency) sensorineural hearing loss in the affected ear, pure tone audiometry test is typically conducted to assess the degree and extent of hearing loss by identifying the hearing threshold levels at various frequencies. Other tests such as the auditory brain stem response (ABR), computer tomography (CT scan) or, magnetic resonance imaging (MRI) may be needed to rule out other causes such as tumor occurring on the hearing or balance nerve.

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Tumours on the hearing nerve (indicated by the red circle) can cause symptoms similar to Meniere’s disease

Treatment of Meniere’s Disease

Meniere’s Disease does not have a cure yet. However, staying happy, avoiding tobacco, alcohol and tea can help to reduce the recurrence. Another common way to combat Meniere’s disease is to eat less salt. High salt intake makes one’s body hold extra fluid and results in fluctuations in the inner ear fluid pressure.  Diuretics might be prescribed to reduce salt levels. When dizziness happens, patients can take anti-dizziness medication orally or lie down to rest. If vomiting continued, patient might be required for intravenous hydration to replenish the fluid loss.

Surgical treatment could be performed on those serious cases to drain the excess endolymph fluid in the inner ear or cut of the nerves responsible for balancing. However, surgery might put patients at risk of hearing impairment or facial nerves paralysis. Therefore, surgery is the last resort for persons who have severe disabling attacks and pre-surgery assessment is necessary.

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