Information on Meniere’s disease
In 1861, the French physician Prosper Ménière described a condition which now bears his name. Ménière’s disease is a disorder of the inner ear which causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear, and fluctuating hearing loss. In figure 1, the area of the ear affected is the entire labyrinth, which includes both the semicircular canals and the cochlea.
No one knows the cause. Meniere’s disease has something to do with fluid in canals of the inner ear. Although it can be troublesome, Meniere’s is not contagious and it isn’t fatal. However, it’s a “chronic” problem, which means that it lasts a long time. People with Meniere’s disease don’t have symptoms all the time. When symptoms occur, it’s called an “attack.” Attacks may happen often, or only sometimes. Attacks usually last from 20 minutes to 2 hours or longer. Meniere’s disease usually occurs in only one ear. It affects both ears in only about 30% of patients.
The exact cause of Ménière’s disease is not known, but it is believed to be related to endolymphatic hydrops or excess fluid in the inner ear. It is thought that endolymphatic fluid bursts from its normal channels in the ear and flows into other areas causing damage. This may be related to swelling of the endolymphatic sac or other tissues in the vestibular system of the inner ear, which is responsible for the body’s sense of balance. The symptoms may occur in the presence of a middle ear infection, head trauma or an upper respiratory tract infection, or by using aspirin, smoking cigarettes or drinking alcohol.
The symptoms of Ménière’s disease are associated with a change in fluid volume within a portion of the inner ear known as the labyrinth. The labyrinth has two parts: the bony labyrinth and the membranous labyrinth. The membranous labyrinth, which is encased by bone, is necessary for hearing and balance and is filled with a fluid called endolymph. When your head moves, endolymph moves, causing nerve receptors in the membranous labyrinth to send signals to the brain about the body’s motion. An increase in endolymph, however, can cause the membranous labyrinth to balloon or dilate, a condition known as endolymphatic hydrops.
The fluid-filled hearing and balance structures of the inner ear normally function independent of the body’s overall fluid/blood system. In a normal inner ear, the fluid is maintained at a constant volume and contains specific concentrations of sodium, potassium, chloride and other electrolytes. This fluid bathes the sensory cells of the inner ear and allows them to function normally.With injury or degeneration of the inner ear structures, independent control is lost, and the volume and concentration of the inner ear fluid fluctuates with changes in the body’s fluid/blood.
Medical treatment of Meniere’s Disease is aimed at decreasing the amount of fluid in the inner ear. This is accomplished by following a low salt diet and taking a diuretic (water pill). Salt (sodium chloride) causes water to be retained by the body; therefore, by reducing the amount of salt in the diet less fluid will be retained. A diuretic is taken on a routine basis to further reduce the amount of fluid in the body. The above treatments are aimed at controlling the disease process and can be used for many months or years.
