Menieres Disease


Theresa Pitt, Aud.D., F.S.H.A.A., Audiology Services in S.E. Ireland.


(Acknowledgements to the Otolaryngology Department at the University of Washington)
Meniere's Disease
Meniere's disease, first described in 1861 by the French physician Prosper Meniere, is characterized by multiple symptoms, all associated with excessive fluid in the inner ear involving both the hearing and balance organs. Excessive fluid in the cochlea (hearing organ) = cochlear hydrops. Excessive fluid in the semicircular canals (balance organ) results in dizziness and is vestibular hydrops. Almost all Meniere's patients have both cochlear and vestibular hydrops.

NORMAL HEARING:
Sound travels along the external ear canal, causing the eardrum to vibrate. Three small bones of the middle ear (malleus, incus, and stapes) conduct this vibration from the ear drum to the cochlea of the inner ear, causing waves of fluid in the cochlea to stimulate its delicate hearing cells (hair cells). Movement of the hair cells generates an electrical current in the auditory nerve, which in turn transmits signals to the brain. Through various interconnections these signals are recognized as sound.

SYMPTOMS:
The symptoms of Meniere's are dizzy spells (vertigo) associated with hearing loss, tinnitus, and a feeling of fullness in the ear. These spells occur to varying degrees and last from 20 minutes to a full day. About 80 percent of patients with Meniere's experience the problem in only one ear. Meniere's can occur at any age but it most frequently begins between the ages of 30 and 50. The cause of Meniere's is unknown. Possible contributors are stress, excessive salt intake, and, occasionally, endocrine problems, such as low thyroid function, abnormal glucose (sugar) metabolism, or an inability to handle fats (high cholesterol and/or triglycerides.) Uncommon disorders that mimic Meniere's are auto-immune labyrinthitis, syphilis, head injury, or viral infection of inner ear.

EVALUATIONS:
Tests determine the existence and cause of Meniere's in each patient, though it is not necessary to perform all the tests listed below in every case. Tests are: