Meniere’s Disease: An Audiologist Explains
Ménière’s disease is a disorder of the inner ear that affects balance and hearing. It can cause episodes of vertigo, ringing in the ears, and hearing loss. I’m Dr. Amy, a Doctor of Audiology and an expert in hearing loss. As an audiologist, I’ve worked with many patients with Ménière’s disease. Fortunately, there are treatments available to help manage symptoms. Let’s look at the symptoms, causes, and treatments associated with this condition.
Symptoms of Ménière’s Disease
The most common Ménière’s disease symptoms are vertigo attacks, hearing changes, ear fullness, and tinnitus (often a roaring sound). In most cases, only one ear is affected. However, vertigo in the affected ear can sometimes be so severe that some people cannot stand up or walk. These symptoms usually appear as sudden attacks and can occur without warning. However, the individual may feel normal between attacks with restored hearing and no dizziness. The frequency of attacks varies from patient to patient; some may experience them daily, while others may only have one episode per year.
I don’t have vertigo – do I have Ménière’s Disease?
Classic Ménière’s disease (MD) includes episodes of room-spinning vertigo, changes in hearing, ear pressure (aural fullness), and tinnitus. However, it is essential to be adequately evaluated to determine whether symptoms are due to MD or another cause. Those who experience fluctuations in hearing without episodes of vertigo do not have classic symptoms. Several conditions can cause these symptoms, including autoimmune inner ear disease, vestibular schwannoma, or other conditions. Cochlear hydrops is a variation of Ménière’s that does not include episodes of vertigo but is characterized by fluctuations in hearing.
What Causes Ménière’s Disease?
The exact cause of Ménière’s disease is unknown; however, it is believed to be related to inner ear fluid levels (endolymph), leading to temporary changes to the chemical balance and structures within the inner ear. Changes to the endolymph in the inner ear can temporarily worsen hearing and balance, resulting in dizziness and other symptoms associated with Ménière’s disease. Several factors may increase your likelihood of this condition, including age (Ménière’s typically affects people between 40-60 years old) and family history.
What are drop attacks?
Sometimes an episode of dizziness can feel like you are falling; this is known as a drop attack. While unpleasant, not everyone with Meniere’s disease experiences this symptom. A drop attack, while jarring, is typically a short-lived symptom. Vertigo attacks can last minutes or hours, but drop attacks are brief.
Does Meniere’s cause temporary or permanent hearing loss?
Unlike other forms of temporary muffled hearing, Meniere’s is not caused by changes in the middle ear (e.g., fluid or infection). Instead, it is a form of sensorineural hearing loss which affects inner ear function. A viral infection does not cause Ménière’s disease. These changes in hearing occur due to chemical changes in the inner ear, which disappear entirely between episodes.
Diagnosing Meniere’s disease
If you believe you are developing Ménière’s disease, it’s essential to have a general physical examination to rule out other causes of vertigo symptoms. In addition, there are other conditions with similar symptoms, so it is necessary to have the proper diagnosis.
Hearing Test
Following a physical exam, you’ll have a hearing test to determine which part of the ear is causing hearing loss: the outer ear, the middle ear, or the inner ear. The audiogram comprises three parts: air conduction, bone conduction, and speech understanding. The results of each test determine which part of the ear is affected. You’ll want to see an audiologist for a comprehensive hearing evaluation.
When to see a doctor of hearing healthcare
Vestibular Tests
If you have vertigo or dizziness, you’ll have a test to assess the vestibular nerve for signs of vestibular nerve dysfunction. These tests may include a videonystagmography (VNG), vHIT, posturography, rotary chair, or electrocochleography (eCoG). VNG is the most common test of the balance system, and vHIT and rotary chair are often done in addition to gathering more information about the vestibular nerve, saccule, and utricle. Electrocochleography measures electrical activity from the cochlea using an electrode placed on the eardrum.
Treatments for Ménière’s Disease
Treatment for Ménière’s disease comes in two varieties: 1) reducing symptom frequency and severity, such as dizziness episodes, and 2) treating hearing loss. Let’s talk more about each.
One of the best ways to help manage symptoms of Ménière’s disease is to eat a low salt diet. Individuals with Meniere’s disease are more sensitive to changes in the chemical makeup of the endolymph related to sodium levels.
Read more here
Therefore, many patients find that closely monitoring sodium intake helps reduce the frequency and severity of symptoms. A physician may also recommend diuretics or other medications to help with fluid retention.
To treat hearing loss, patients can try several options. If speech clarity is sufficient, a traditional hearing aid can help.
However, speech clarity is impaired for some patients with Meniere’s disease, and a CROS hearing aid system is a better option. A cochlear implant is sometimes an option for those with more severe hearing loss.
Cochlear implants vs. hearing aids
Due to the fluctuating nature of hearing loss with Meniere’s disease, hearing aids can be programmed with several programs depending on how the patient is doing that day.
Conclusion:
As you can see, many aspects are involved when it comes to an understanding what causes Ménière’s disease and how best to treat it if you think you might have it. To learn more about this condition, talk with your doctor about any concerns you might have regarding its diagnosis or treatment options that could be beneficial for relieving uncomfortable symptoms like dizziness, hearing loss, or tinnitus. Fortunately, there are methods to help you hear and feel better with Meniere’s disease.
