3. Introduction
Meniere'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
There is no single known cause for Meniere’s Disease
4. Proposed theories;
1. Endolymphatic hydrops
Autopsies show the inner ear membranes distension
(hydrops)
The theory is that progressive dilation of the inner ear
structures causes micro-ruptures in the delicate
membranes causing contamination of the inner ear
nerve endings
What causes this dilation is unknown
5. Cont…
2. Autoimmune:
There is evidence that the body’s own immune
mechanism may be responsible for this disorder
Researchers have found antibodies to inner ear
proteins circulating in the bloodstreams of many
patients with the disorder
6. Cont…
3. Anatomy:
The endolymphatic sac is thought to be responsible for
cleansing the inner ear fluids. Physical abnormalities
of the bone surrounding the sac may be responsible for
dysfunction of this cleansing system
4. Viral:
Viral particles have been identified within the inner
ear of many Meniere’s patients
9. Diagnosis of Meniere’s Disease
Periodic episodes of rotatory vertigo or dizziness
Fluctuating, progressive, low-frequency hearing loss
(bass) + loudness intolerance; usually unilateral
Tinnitus; directly temporally related to the vertigo and
hearing loss episodes
Aural fullness
10. Other symptoms that may be
present;
Hyperacusis
Extreme fatigue
Vision problems
Photosensitivity
Mood swings
Mental disorientation
Poor physical coordination
11. Diagnostic Testing
Testing is rarely helpful in the diagnosis
Audiologic evaluation (hearing test) most helpfull
-The typical “Meniere’s pattern” is a low frequency
sensorineural hearing loss. Later on the hearing loss
becomes moderate to severe
12. Cont…
ENG (Electronystagmogram) testing is often done
but is also of limited usefulness, although important in
documenting the health of the balance system in the
other ear
ECoG (electrocochleography); previously used, was of
little benefits no more recommended
13. Treatment
Diet and drugs: initially treated conservatively with a
salt restriction diet and diuretics
Transtympanic gentamicin injection (chemical
labyrinthectomy)
-This procedure takes advantage of the toxic effects of
the drug to poison and weaken the balance nerve
ending in the diseased ear
-Complication; further hearing loss that may be
permanent and profound
14. Cont…
Endolymphatic Sac Shunt (decompression
procedure); drains excess endolymph from the inner
ear. Usually preserves hearing
Vestibular Neurectomy; the balance nerve is cut as it
leaves the inner ear and goes to the brain/ through
mastoidectomy the balance nerve is cut before it
enters the inner ear. Vertigo attacks are permanently
cured and hearing is preserved in most cases
15. Cont…
Labyrinthectomy and Eighth Nerve Section;
The balance and hearing mechanism in the inner ear
are destroyed on one side
This is considered when the patient with Meniere's
disease has poor hearing in the affected ear
Has the highest rates for control of vertigo attacks
16. REFERENCES;
Otolaryngology – Basic Science and Clinical Review, 1E
2006
Diseases of the Ear,Nose and Throat P.D. BULL, Ninth
Edition
Medscape
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