Meniere’s disease

21:54 - 4 May , 2021

Disease

What is Meniere’s disease?

It is a condition of the inner ear that causes intense dizziness, pain, pressure, tinnitus, and partial or total loss of hearing, usually affecting one of the two ears. Although Ménière's disease can occur in people of all ages, it is most common in young and middle-aged adults. Being a chronic condition, the treatment seeks to control the symptoms, improve the patient's quality of life and avoid complications. The origin of this condition is yet unknown, but it is related to an excess of fluid or endolymph in the inner ear, which can occur due to some morphological abnormality that obstructs its drainage, due to viral infections, genetic aspects, or immunological reactions.

Symptoms

  • Sudden attacks of dizziness and vertigo lasting from a few minutes to 24 hours.
  • Nausea.
  • Vomit.
  • Auditory congestion.
  • Tinnitus.
  • Decrease or loss of hearing
At the end of an attack, the symptoms decrease or disappear for a while. However, it is important to know if there is an underlying disease that is causing the symptoms. Therefore, you should go to a doctor to obtain an accurate diagnosis and timely treatment. Complications caused by this disorder include injuries, falls, and accidents due to vertigo attacks, as well as total hearing loss.

Diagnosis and treatment

Once your doctor analyzes your symptoms and clinical history, they will perform a physical examination and perform a series of tests to determine the diagnosis, including an audiometry to evaluate your hearing capacity through different sound stimuli, various balance tests such as videonystagmography and evoked potentials, as well as an electrocochleography to know if there is fluid trapped in the inner ear. They may also order blood tests, CT scans, and MRIs to make sure no other underlying conditions are causing the symptoms. The treatment plan focuses on controlling symptoms and reducing the frequency of attacks, but it is not possible to reverse the hearing damage. The most used drugs are:
  • Drugs to counteract dizziness and nausea.
  • Diuretics to prevent fluid retention.
  • Gentamicin injected into the ear.
  • Steroids injected into the ear.
Similarly, your doctor may recommend vestibular rehabilitation therapy, placement of a hearing aid in the affected ear, and positive pressure therapy. If pharmacological treatments and non-invasive therapies do not give good results and the symptoms are severe and incapacitating, the option is surgery, and procedures such as endolymphatic sac, labyrinthectomy, and vestibular nerve cutting can be recommended. The latter is the most used because it fulfills the double purpose of solving vertigo problems and preventing hearing capacity deterioration of the damaged ear. At ABC Medical Center’s Internal Medicine Department, we offer health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies of both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

Fuentes:

  • cun.es
  • mayoclinic.org
  • medlinesplus.gov
  • msdmanuals.com
  • topdoctors.es
  • medigraphic.com
  • Ramírez-Arroyo G, Carrillo-Pacheco E. Papel de la terapia intratimpánica con gentamicina en el tratamiento de la enfermedad de Ménière. Otorrinolaringología. 2021;66(3):220-228.
  • Hinojosa-González R, Morales-Orta C, Vales-Hidalgo O, et al. Utilidad de los potenciales miogénicos evocados vestibulares cervicales (PMEVc) en el control de ablación vestibular total con gentamicina en la enfermedad de Ménière unilateral con vértigo, sin respuesta a tratamiento médico. Arch Neurocien. 2011;16(4):223-227.
  • Ried UE, Ried GE, Martínez C. Hallazgos de las causas de la enfermedad de Ménière. Otorrinolaringología. 2007;52(2):48-52.
  • Bermúdez-Tirado NK, Zazueta-López IB, Celis-Aguilar EM, et al. Encuesta nacional del tratamiento de la enfermedad de Ménière. Otorrinolaringología. 2019;64(3):75-83.

						
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