August 3, 2012

Ask the Audiologist: What is Meniere’s Disease

Flint,-Rachel-colorBy Rachel Flint, Au.D.
Audiology Consultants, P.C.

What is Meniere’s Disease

Meniere’s disease is a condition that occurs in the inner ear. It is somewhat common, but not always well defined. According to the Mayo Clinic’s website, “Meniere’s disease is a disorder of the inner ear that causes spontaneous episodes of vertigo — a sensation of a spinning motion — along with fluctuating hearing loss, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear.” This may seem a little complicated. If we break it down, it will be easier.

The first thing we need to understand is what the inner ear is. The inner ear is part of the ear that is embedded in the skull and is filled with fluid. Within this area, there are organs for hearing (the cochlea) and organs for balance (semicircular canals and otoliths). All of these different organs are directly connected to each other and share fluid.

The next thing we need to cover is vertigo. Many times, when we are dizzy, it is difficult to describe what we are feeling. When you discuss your symptoms with your doctor, they will ask you more specific questions about what you are feeling. Your doctor is trying to find out if what you are experiencing is true vertigo or some other type of dizziness. Vertigo is a false sensation of movement and is usually described as feeling that you are spinning or that the room is spinning around you. Your body knows you are not moving, but your brain is getting information from the inner ear that says you are, which causes you to feel dizzy. Occasionally some people will describe more of a rocking sensation. However, in Meniere’s disease, the described symptoms are almost always a spinning sensation that lasts for hours.

Tinnitus is a noise that is originating within the head or the ear, and does not have an outside source. Most people describe this as ringing in the ears. With Meniere’s disease, most people describe more of a roaring or buzzing sound in the affected ear. This sound usually gets louder just before or during an episode of vertigo. The other symptom that accompanies the tinnitus is loss of hearing or a feeling that the ear is full or has pressure. Over time, one with Meniere’s disease is likely to gradually loose hearing in the affected ear permanently. However, there will still be fluctuations in hearing with the onset of vertigo.

So, what is happening to cause all of these symptoms? Remember the inner ear is connected and full of fluid? In Meniere’s disease, there is too much of this fluid in the affected ear. Most of the time, only one ear is affected in Meniere’s disease. We still are not completely sure of the cause of this build up in fluid. We do know, however, that if we try to manage the buildup of fluid, either through diet or medications, we can usually manage the symptoms.

If you think you have Meniere’s, please discuss your symptoms with your doctor in detail. There are tests that could be done to investigate, such as a hearing evaluation or what is known as the VNG. The VNG is a set of tests that let us examine the balance portions of the inner ear to determine if there is damage in that area. If it is determined that you have Meniere’s disease, your doctor will help you find the best way to manage it. There is no cure for Meniere’s disease. Management of the symptoms is usually done with regulating the amount of salt you eat or by using medications, known as diuretics, which help regulate fluid levels in your body. Sometimes vestibular rehabilitation therapy is prescribed. This involves working with a physical therapist to learn some exercises that will help your brain adapt to using the information from your inner ear and help you regain your balance. Some physicians will also prescribe medication to be taken during a vertigo attack to try to reduce the severity of the vertigo.

An audiologist can help with the symptoms of hearing loss. In many cases, using a hearing aid on the affected ear can help to improve hearing in the affected ear. Regular hearing evaluations are also recommended to monitor for changes in hearing. The earlier permanent changes to hearing are detected, the easier it is to manage the hearing loss with a hearing aid.

Even though there is no cure and Meniere’s disease can be difficult to live with, there are many resources available to help. The best thing is to discuss your symptoms and situation with your doctor and work with your doctor to find the best set of solutions for you. There is also a lot of research being done on finding the causes and effective treatments for Meniere’s disease, so new things may become available down the road.

References:, December 2011