Ménière’s disease (also called idiopathic endolymphatic hydrops) is one of the most common causes of dizziness originating in the inner ear. In most cases only one ear (unilateral) is involved, but both ears (bilateral) may be affected.
Ménière’s disease typically affects people between the ages of 40- and 60-years-old and can impact anyone. Occasional symptoms include vertigo (attacks of a spinning sensation), hearing loss, tinnitus (a roaring, buzzing, or ringing sound in the ear), and a sensation of fullness in the affected ear. These episodes typically last from 20 minutes up to eight to 12 hours.
Hearing loss is often intermittent, occurring mainly at the time of the attacks of vertigo. Loud sounds may seem distorted and cause discomfort. Usually, the hearing loss involves mainly the lower frequencies, but over time this often affects higher tones as well. While hearing loss initially fluctuates, it often becomes more permanent as the disease progresses.
What Are the Symptoms of Ménière’s Disease?
Ménière’s disease symptoms may include:
- Dizziness or vertigo (attacks of a spinning sensation)
- Hearing loss
- Tinnitus (a roaring, buzzing, or ringing sound in the ear)
- Sensation of fullness in the affected ear
- Symptoms tend to come and go together
What Are the Treatment Options?
Although there is no cure for Ménière’s disease, the attacks of vertigo can be controlled in nearly all cases. Treatment options include:
- A low salt diet and a diuretic (water pill)
- Anti-vertigo medications (used to stop acute attacks)
- Intratympanic injection with either dexamethasone or gentamicin
- Surgery
Your ENT (ear, nose, and throat) specialist, or otolaryngologist, will help you choose the treatment that is best for you, as each has advantages and drawbacks. In many people, careful control of salt in the diet and the use of medication to help release extra fluid can control symptoms well.
Treatments aim to save the inner ear parts that work and clear out parts that are permanently injured.
Intratympanic injections inject medication through the eardrum into the middle ear space where the ear bones reside. This treatment is done in your ENT specialist’s office one or more times. One type of medication, Gentamicin, eases dizziness but may increase hearing loss and worsen overall balance. Corticosteroids do not cause hearing loss but are less helpful for dizzy spells.
Surgery
Surgery is needed in only a small minority of patients with Ménière’s disease. If vertigo attacks are not controlled by conservative measures and are disabling, a surgical procedure might be recommended.
Labryrinthectomy and eighth nerve section are procedures in which the balance and hearing mechanism in the inner ear are destroyed on one side. This is considered when the patient with Ménière’s disease has poor hearing in the affected ear. Labryrinthectomy and eighth nerve section result in the highest rates for control of vertigo attacks.
What Should I Do If I Have an Attack of Ménière’s Disease?
Lie flat and still, and focus on an unmoving object. You might even fall asleep while lying down and feel better when you wake up.
Take vestibular suppressants including meclizine, which calm the inner ear.
To help prevent an attack, avoid stress and excess salt ingestion, caffeine, smoking, and alcohol. Get regular sleep and eat properly. Remain physically active, but avoid excessive fatigue. Consult your ENT specialist about other treatment options.
Call Rocky Top ENT & Allergy at 931-219-9990 or 865-383-0737 for more information and to schedule an appointment.