Meniere’s disease (MD) is a condition characterized by symptoms which include ear pressure, vertigo, tinnitus (ringing or buzzing in the ear), and fluctuating hearing loss. The disease is thought to come from an abnormal balance of the inner ear fluid compartments. The imbalance results in excess fluid accumulation in the inner ear and disturbance of the sensitive nerve endings that control hearing and balance. The condition usually occurs in only one ear and is most common in adults in their 40s and 50s, but can be seen in children and adults of all ages. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), over 600,000 people in the US have Meniere’s disease.
Diagnosis is usually made on a clinical basis, but there are several objective tests that can help. There are many options for the management of Meniere’s disease that DO NOT involve surgery. Over half of all MD patients show significant improvement simply by avoiding salty foods/caffeine/alcohol, changing dietary habits, and exercising regularly. Many patients may also benefit from using diuretics. Diuretics help remove excess inner ear fluid. Some MD patients may require steroids orally or via a direct injection to the middle ear through the eardrum.
Surgical options also exist for patients who fail to show improvement with the above treatment options. Surgical options include: endolymphatic sac decompression and shunting; intratympanic gentamycin injection (an antibiotic that is preferentially toxic to the balance nerve endings); Meniett device; vestibular neurectomy; and labyrinthectomy. Which surgery is chosen depends on objective balance testing results and the degree of residual hearing in the afflicted ear.