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Inner ear

Membranous labyrinth

Preventative measures

  • low salt diet

  • reduce or avoid caffeine

  • reduce or avoid alcohol

  • avoid nicotine

  • improve hydration

  • diuretics

Meniere’s disease

What is Meniere’s disease?

Prosper Meniere was a French Doctor who first described this condition (1861), where patients get recurrent attacks

of vertigo (sensation of spinning), hearing loss, and tinnitus. It was he who suggested that this condition occurs due

to an affection of the inner ear and not the brain as it was thought in those days.

Meniere’s disease, in its classic form, is episodic. In a typical episode a patient experiences four characteristic symptoms which are:

  • Aural fullness – patients describe this as a sense of fullness or pressure in the affected ear. This symptom can herald the onset of an attack of vertigo.

  • Vertigo – sensation of spinning can start suddenly or is preceded by a sense of fullness/pressure in the affected ear. It lasts for hours, is associated with nausea and sometimes vomiting. After the vertigo subsides, a sense of imbalance can persist for some period;  usually a few hours to a day.

  • Hearing loss – during an attack the hearing deteriorates. After an attack, hearing returns back to normal. However, with recurring attacks the hearing loss can persist and become more permanent.

  • Tinnitus – can herald the onset of an attack, and is loud. It can, like hearing loss, become more persistent and disturbing as the disease progresses.

What causes Meniere’s disease?

Within the bone of the inner ear there is membranous labyrinth (see picture) that follows the contours of the bone. This structure contains fluid that is called endolymph.

In Meniere’s disease there is dilatation of the membranous labyrinth due to excess endolymph, akin to a hyper-inflated bicycle tyre. Periodically the ‘tyre’ bursts. This coincides with an attack. The opening seals itself, and the cycle is repeated. The cause for excess production (or reduced absorption) in the first place is unknown.

How is it managed?

  • Diagnosis: This is made on the patients’ history, and hearing test results. Further investigations may be done primarily to rule out other conditions that can present with similar symptoms.

  • Treatment: Currently, there is no cure for Meniere’s disease, but several measures/medication can help control symptoms.

Driving and Meniere's disease

If you have a diagnosis of Meniere's disease you have to inform the DVLA and your car insurers, by law. Further information can be found by clicking here.

Other treatments:

  • Injection of steroid into the middle ear

  • Injection of Gentamicin into the middle ear

  • Surgery

Meniere's Disesae
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