Meniere's Disease: An Overview of Its Causes, Symptoms, and Treatments

Meniere's disease is a chronic inner ear disorder that affects hearing and balance. The condition is named after the French physician Prosper Meniere, who in 1861 theorized that vertigo attacks, tinnitus, and hearing loss occur from the inner ear rather than the brain, as was the belief then.

Today, there are approximately 600,000-750,000 cases of Meniere's disease in the U.S., with 45,000 to 60,000 new cases diagnosed each year. Most cases start as unilateral (affecting only one ear) but progress to bilateral, with almost 15% of individuals with Meniere's disease experiencing bilateral hearing loss.

How Does Meniere's Disease Affect Hearing Health?

The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Foundation defines Meniere’s as "a disorder of the inner ear that includes episodes of vertigo with possible hearing loss, ringing or buzzing in the ear, or ear pressure."

As the disease progresses, it adversely impacts hearing health. A person with Meniere’s may experience temporary hearing loss during the initial stages, and permanent hearing damage can develop in later stages, resulting in profound hearing loss.

Causes and Risk Factors of Meniere's Disease

According to the National Institute on Deafness and Other Communication Disorders, Meniere's disease occurs due to an excess fluid (endolymph) build-up in the labyrinth, a part of the inner ear that contains the organs of balance (semi-circular canals and otolithic organs) and hearing (cochlea). While the exact cause for the fluid build-up is unknown, it may be due to any of the causes mentioned below or a combination of the probable causes.

• Allergic reaction
• Abnormal immune system response
• Poor fluid drainage due to blockage or physiological abnormality
• Head trauma
• Family history
• Migraine headache
• Viral infection

You may be at a higher risk of having Meniere's disease if:

• You are between the ages of 40-60 years
• Someone in your family has the condition
• You have an autoimmune disorder

Signs and Symptoms of Meniere's Disease

Meniere's disease symptoms often begin with attacks of vertigo or dizziness, which can last between 20 minutes to 12 hours or longer. Other symptoms can include:

• Fluctuating hearing loss or muffled hearing
• Inability to hear low-frequency sounds
• Nausea, sweating, and vomiting
• Loss of balance
• The sensation of ear fullness, also known as aural fullness 
• Tinnitus (ringing or other noises in the ears)
• Headaches 
• Abdominal pain
• General feeling of unwellness

As the condition progresses, hearing may worsen, and tinnitus may become constant.

Will Meniere's Disease Go Away?

Meniere's disease is a chronic condition that does not go away on its own, and it does not yet have a cure. However, with the proper treatment: 

• Symptoms can be managed
• Severity of vertigo attacks decreases
• Reduced frequency of symptoms

Stages of Meniere's Disease

Meniere's disease includes three stages, with each stage having its unique symptoms and health-related complications. The stages are:

• Stage One

This is the initial stage of the disease, during which the sufferer may experience hearing loss and vertigo with varying degrees of dizziness. An “aura” accompanied by balance issues may be observed just before an attack. The attacks become more frequent and severe and can include vertigo, migraine, sound sensitivity, tinnitus, growing sensation of pressure in the ear, and hearing impairment.

• Stage Two

While the severity of the attacks may lessen during this stage, the sufferer may experience increased hearing damage and coordination issues.

• Stage Three

Tinnitus, hearing loss, and the sensation of fullness within the ear may continue and worsen. Hearing loss, at this stage, usually will be permanent. Balance, coordination, and depth perception may also continue to be affected.

Diagnosis and Treatment Options for Meniere's Disease

For an accurate diagnosis of the condition, a physician will:

• Ask for a complete medical history, including family history
• Perform a physical examination

They may recommend specific tests such as:

1. Hearing test (Audiometry): To detect how well sounds are heard at varying pitches and volumes.
2. Balance test: To study the inner ear's functioning, the physician may perform the following: 
   • Electronystagmogram or videoystagmogram (ENG or VNG)
   • Rotary-chair testing
   • Electrocochleography (ECoG)
   • Vestibular-evoked myogenic potentials (VEMP) testing
   • Computerized dynamic posturography (CDP)
   • Video head impulse test (vHIT)
3. Magnetic resonance imaging (MRI) scans: To screen for the possibility of a tumor.

Treatment

The condition has no cure, but depending on specific symptoms, a physician may provide the following treatment options:

1. Medication:
   • To reduce fluid build-up in the inner ear
   • To boost blood circulation in the inner ear
   • To manage symptoms such as vertigo and nausea
2. Non-invasive therapies:
   • Hearing aid: To improve hearing impacted by the illness
   • Vestibular rehabilitation: To improve balance issues
3. Surgery:
   • Endolymphatic sac surgery
   • Labyrinthectomy
   • Vestibular nerve section

When Should You Consult a Doctor for Meniere's Disease?

If you experience frequent bouts of dizziness along with hearing issues and/or ringing in the ears, you should visit an audiologist or MD right away. Proper diagnostic tools and evaluations can identify the causes of your problems and provide suitable treatment options.

Get Optimum Management for Your Meniere's Disease Symptoms at Hoffmann Audiology

At Hoffmann Audiology, our licensed hearing care professional, Dr. Chris Hoffmann, provides a full range of diagnostic evaluations and consultations to offer quality care and hearing solutions to our patients in and around Irvine, including Tustin, Costa Mesa, and Lake Forest. For more details of our services or to book an appointment, contact us today.