Ménière’s disease (also known as idiopathic endolymphatic hydrops) is a rare disorder of the inner ear that can cause occasional vertigo (spinning motion), tinnitus (ear ringing), episodic hearing loss, and ear fullness.
Ménière’s disease is a chronic condition that has no known cause. It is believed to be related to the abnormal accumulation of a clear fluid (endolymph) in the inner ear. Ménière’s disease can be diagnosed through a combination of medical history, physical examination, and hearing and balance tests. Treatment for Ménière’s disease may include medication, lifestyle changes, or in severe cases, surgery.
The following sections will discuss some of the key aspects of the disease and provide some tips on how to manage symptoms and improve your quality of life.
The term “endolymphatic hydrops” is used for both Ménière’s disease and Ménière’s syndrome. The key difference between these two conditions is merely their cause. Ménière’s disease does not have a cause which means it is “idiopathic” while Ménière’s syndrome happens as a result of any event that leads to increased pressure in the endolymphatic system. This could be disease, trauma, medications, infections, or tumors. Therefore whenever a cause is found for the symptoms of Ménière’s disease, it by default becomes Ménière’s syndrome.
Ménière’s disease, despite having an unknown cause, has a number of factors associated with it, signs and symptoms that hint at the disease, and a patient-specific method of treatment.
Signs And Symptoms Of Ménière’s Disease
Hearing loss: This varies in degree and might be episodic
Vertigo: Vertigo is the feeling of being in motion while one is motionless and can often be accompanied by nausea or vomiting
Dizziness: One of the major functions of the inner ear is to maintain balance
Hearing Loss: Some people might experience complete, partial, or transient hearing loss
Tinnitus: A low, whistling sound that may be constant or intermittent. It often occurs at the same time as the loss of hearing
Causes Of Meniere's Disease
Half of the patients diagnosed with Ménière’s disease have a family member that has had the disease.
Infections by microbes like bacteria and viruses might disrupt the balance of endolymph in the ear as these infections sometimes lead to swelling and formation of pus.
Autoimmune disorders occur when your body’s defences overreact and attack the body itself. When this happens in the ear it can cause inflammation and damage that may lead to Ménière’s disease.
Management And Treatment For Meniere's Disease
There is no definitive treatment or cure for Ménière’s disease. The specific approach to therapy will depend on the severity of the symptoms and other patient-specific factors.
Medications: Medications such as diuretics are often used to help relieve pressure in the ears as that is the major cause of the symptoms of the disease. Other medications that could be used to improve symptoms are antiemetics (nausea and vomiting treatments) and steroids
Surgery: Surgery is often employed as a last resort when other therapy has failed. This is mostly controversial as it sometimes involves the destruction of a nerve in the ear to relieve symptoms
Lifestyle modification: A low sodium diet is thought to help symptoms of mild disease as it helps reduce total body water volume which would reduce the amount of fluid in the inner ear. Since Ménière’s disease also affects a person's balance, it is advised that balance-intensive activities should be avoided.
Diagnosis Of Ménière’s Disease
Diagnosis is based on medical history, hearing, and balance tests. Your doctor may order some imaging tests to exclude other possible causes of your symptoms. There are a number of guidelines for diagnosing Ménière disease.1
How Can I Prevent Ménière’s Disease?
Because it is not known what causes Ménière’s disease, it is difficult to definitively suggest ways to avoid it. Good practices in keeping with ear health are a good way of eliminating factors that might disrupt the ears’ natural balance. If you experience any of the symptoms of the disease, it is important to see a doctor to receive a proper diagnosis and begin appropriate treatment.
How Common Is Ménière’s Disease?
The prevalence of Ménière’s disease is difficult to estimate as it is often underreported. It is estimated to affect 190 per 100,000 persons in the United States.2
Who Is At Risk of Ménière’s Disease?
Anyone can develop Ménière’s disease, it has been observed in children as young as 4 and adults older than 90. It has however shown an increased incidence in 40-60 year olds.3 The likelihood of developing the disease increases with age. It is also thought to be more common in people assigned female at birth (AFAB) than people assigned male at birth, but this opinion might likely be due to the fact that people AFAB are more likely to seek treatment. Conditions like migraines and hypertension may increase one’s likelihood of developing Ménière’s disease. Exposure to loud noises for extended periods of time and a history of head trauma may also be associated with higher risk.
When Should I See A Doctor?
You should see a doctor to get evaluated if you experience unexplained dizziness, tinnitus, hearing loss, or a feeling of fullness in your ears.
Ménière’s disease is a condition of the inner ear that can cause symptoms such as vertigo, tinnitus, and ear fullness. Its exact cause is unknown, but genetics, infections, and autoimmune disease are thought to play a role in the disease process. It can affect persons of any age but has been found to be more common in middle age. Treatment often includes medication for symptomatic relief, dietary and lifestyle changes, or surgery in cases that could not be improved by lifestyle changes or medication. Diagnosis involves a combination of medical history, physical examination, and hearing and balance tests.
- Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R, et al. Clinical practice guideline: ménière’s disease executive summary. Otolaryngol--head neck surg [Internet]. 2020 Apr [cited 2023 Apr 14];162(4):415–34. Available from: https://onlinelibrary.wiley.com/doi/10.1177/0194599820909439
- Alexander TH, Harris JP. Current epidemiology of Meniere’s syndrome. Otolaryngol Clin North Am. 2010 Oct;43(5):965–70.
- Meniere disease (Idiopathic endolymphatic hydrops): background, anatomy, pathophysiology. 2021 Oct 18 [cited 2023 Apr 14]; Available from: https://emedicine.medscape.com/article/1159069-overview#a6