Meniere’s disease leads to an increase in fluid volume in the labyrinth. The labyrinth, a chamber in the inner ear filled with fluid, continuously manages positions and movements of the head, and sends information to the brain, which allows maintaining balance. Increased pressure, caused by excess liquid, distorts or even damages the nerve cells in the wall of the labyrinth by hindering the sense of balance. The adjacent cochlea may be damaged and the result is a weakening of the hearing. The disease attacks one ear and then the other one in 50% of the patients.
In most cases the symptoms are mild or there are no symptoms at all, but seizures occur periodically. The frequency of seizures is different, they can occur every few weeks or every few years, and last from several hours to a few days.
The main symptom is a dizziness, which can last from several minutes to several hours, and is often accompanied by ringing in the ear, weakened or distorted hearing (especially low tones). At the same time, severe nausea and vomiting can occur. Sometimes the patient feels pressure in the affected ear before or during the seizure. In persistent cases of disease, symptom such as hearing loss can still be present, even after the seizure.
Meniere’s disease is not common; it will affect only one out of 2000 people annually. For reasons unknown, Meniere’s disease attacks mostly people with light tan and blue eyes. Medicine has not yet been able to figure it out.
In most people this disorder is light and disappears by itself, but in some cases there may be total deafness in one or both ears. In these difficult cases, anxiety and migraine occur. Dizziness is also a serious problem, because a person can hurt himself.
What to do?
If you have any of the symptoms described, contact your doctor immediately. Your doctor will probably send you to a hospital for tests that can last for two to three days.
The first test will probably be audiometry. If the results point to Meniere’s disease, but do not confirm the diagnosis, the test will be repeated after dehydration. You will not be allowed to drink before the test and you will be given a diuretic; this will reduce the amount of fluid (and thus pressure) in the labyrinth. If the second test shows that your hearing has somewhat improved, it is a convincing proof that you have Meniere’s disease.
If your doctor still doubts about the diagnosis, he will send you to further tests. In one of them, called a vestibular functional test, the ear is filled with water of different temperatures. After each filling you feel like you are in a whirlwind, and it will make your eyes blink. The duration of blinking indicates whether the labyrinth is healthy or not.
In rare cases, it may also be necessary to perform a third test called the tympanometry; a general anesthesia is required for this examination.
Self-help: lying still during the seizures can ease the symptoms. General limitation of fluid and salt intake may reduce the frequency and strength of seizures by reducing the volume of fluid in the labyrinth.
Professional help: in most cases, the doctor will recommend the vasodilators to reduce excess fluid in the labyrinth; for acute seizures, you can also get relief agents to reduce anxiety that can aggravate the seizure.
If, despite the treatment, there is so much fluid in the labyrinth which damages it, even though hearing is not yet seriously distorted, a surgical procedure is performed. The doctor will cut an opening into the labyrinth, through the middle ear, for fluid drainage. This operation not only prevents further hearing loss in the affected ear, but also improves it in some cases.
If the disease is so severe that dizziness (caused by the disease) leads to disability, the labyrinth can be destroyed by surgery or ultrasound. This will cure dizziness, but as a side effect, the patient will lose the hearing completely in the affected ear. However, even without the treatment, deafness is inevitable.
Before deciding on such drastic surgery, doctors will consider many factors, including the condition of the patient’s second ear and his age. In some cases, Menier’s disease may disappear without treatment.