Definition

Meniere disease is a disorder of the inner ear. It results in repeat attacks of vertigo and problems hearing.

The Inner Ear
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Causes

The exact cause is not known. It is thought to be caused by many factors, such as:

  • A buildup of fluid in the part of the inner ear known as the labyrinth
  • Genetics
  • Problems with the immune system
  • Infection
  • Trauma

Risk Factors

This problem is more common in people who are 30 to 60 years of age. Other things that may raise the risk are:

  • Having other family members who have this health problem
  • Pressure changes in the atmosphere
  • Allergies
  • Stress
  • Changes in hormones
  • Problems sleeping
  • Dietary changes, such as an increase in salt, caffeine, or alcohol
  • Excessive sweating followed by a sudden increase in fluids

Symptoms

Problems may come and go. They may also be in one or both ears. A person may have:

  • A sensation of spinning while standing still
  • Balance problems
  • Nausea and vomiting
  • A feeling of fullness or pressure in the ear
  • Ringing in the ear(s)
  • Problems hearing

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the ears. You may need to see a doctor who treats ears.

A hearing test will be done.

  • MRI scan —to look at internal structures of the ear
  • Electrocochleogram—to check function of the hearing organ in the inner ear
  • Vestibular evoked myogenic potential test—to check muscle activity in response to sound
  • Caloric testing—to check for nerve damage
  • Glycerol dehydration test—to see whether hearing improves after using a dehydrating agent

Treatment

There is no cure. The goal of treatment is to manage symptoms. Choices are:

  • Medicines to:
    • Ease vertigo
    • Control nausea
    • Reduce fluid buildup
  • Dietary changes, such as limiting salt, caffeine, and alcohol
  • Lifestyle changes, such as reducing stress and safety measures to avoid falling
  • Physical therapy to learn vestibular exercises to get the body used to moving without vertigo
  • A Meniett device that gives low-pressure pulses to the middle ear
  • A counselor or support group to learn how to cope with symptoms

People who are not helped by these methods may need surgery, such as:

  • Endolymphatic sac decompression to remove of a portion of inner ear bone and place a tube in the inner ear to drain excess fluid
  • Labyrinthectomy to destroy or remove the entire inner ear
  • Vestibular nerve section to cut the nerve in the ear that controls balance

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Academy of Otolaryngology—Head and Neck Surgery
http://www.entnet.org

Meniere's
http://www.menieres.org

CANADIAN RESOURCES:

The College of Family Physicians of Canada
http://www.cfpc.ca

Meniere's Disease
http://www.menieres-disease.ca

REFERENCES:

Lopez-Escamez JA, Carey J, et al.; Classification Committee of the Barany Society, Japan Society for Equilibrium Research, European Academy of Otology and Neurotology (EAONO), Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), Korean Balance Society. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7.

Meniere disease. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/meniere-disease. Accessed March 24, 2021.

Meniere's disease. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/menieres-disease. Accessed March 24, 2021.

Meniere's disease. National Institute of Deafness and Other Communication Disorders (NIDCD) website. Available at: https://www.nidcd.nih.gov/health/menieres-disease. Accessed March 24, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD