Ears - Meniere's disease

About Ménière's disease

Meniere’s disease affects the inner ear, which is the centre of hearing and balance. During an attack, the person experiences vertigo – a sensation that they or the world around them is moving. They feel dizzy and sick, their hearing is dominated by a hissing or roaring sound (tinnitus), and one or both ears feel full to bursting point.

Meniere’s disease may develop slowly over time, with a gradual loss of hearing, or suddenly with a vertigo attack. Attacks can last from 10 minutes to several hours.

After an attack, the person may experience mild deafness and feel unsure of their footing. As the disease progresses, the episodes of vertigo become less frequent and the deafness becomes more severe.

Causes of Meniere’s disease

The exact cause of Ménière's disease is unknown but the mechanism causing the symptoms is thought to likely involve the fluid in the inner ear, which moves over the sensory cells that send information to the brain about the position of the head, and sound. Fluid in the inner ear is usually separate from the body’s overall fluid system and contains specific concentrations of ‘salts’ such as sodium, potassium and chloride.

But in Ménière's disease the volume and concentration of inner ear fluid fluctuates with the body’s fluid levels. Over time, the abnormal fluid concentration may cause irreparable damage to the sensory cells responsible for hearing and balance.

Symptoms of Meniere’s disease

An ‘attack’ caused by Ménière's disease involves vertigo that can last from several minutes to hours and is associated with nausea, vomiting and unsteadiness. Other symptoms include tinnitus, which is a subjective noise (such as ringing, buzzing, hissing or rumbling) in the ear that is not associated with any external sound. Progression of Ménière's disease may also lead to aural fullness and a sensorineural ‘nerve’ hearing loss that fluctuates with attacks, and commonly effects the low frequency hearing.

Diagnosis of Meniere’s disease

If referred to a specialist by your GP, diagnosis of your condition will be made based on your medical history, answers to questions about when and where the symptoms occur, a physical examination and the results of tests carried out by
an audiologist, including a hearing test. Other tests may be requested depending on the type and severity of your symptoms.

Treatment for Meniere’s disease

One of the main treatments for Ménière's disease is diet modification to reduce the intake of sodium (salt). The aim of the low sodium diet is to maintain body fluid levels and mineral concentrations so that secondary fluctuations in the inner ear fluid levels can be avoided.

It is also recommended that people with Ménière's disease avoid alcohol, caffeine and nicotine, which can also change the volume and concentration of fluid in the inner ear. Medication can also be prescribed to control body fluid levels and the symptoms of nausea and vomiting, while debilitating cases of Ménière’s disease may require vestibular rehabilitation physiotherapy, injections into the ear, or surgery. It is also thought that stress can influence the frequency
and / or severity of attacks so it is recommended that stress levels be managed as much as possible.

As Ménière’s disease progresses the hearing loss may become permanent. Depending on the severity and stability of the hearing loss and the nerve’s ability to continue processing speech sounds you may find some benefit with a hearing aid. This can be discussed with the audiologist when you are tested.

Where to get help

• Your GP (doctor)
• Hearing specialist – ear, nose and throat specialist (ENT)
• Audiologist
• The Royal Victorian Eye and Ear Hospital.