Dr. Cristina Vaduva
ENT specialist doctor and member of Doctoralia.
Ménière’s disease is a disorder of the inner ear that affects balance and hearing. It is manifested mainly by the presence of vertigo, hearing loss or hearing fluctuation, noises in the ear (also called tinnitus or tinnitus) and a sensation of otic fullness (clogged ear).
The exact cause of the disease is unknown, but it’s thought that excess pressure on the fluid inside the inner ear that controls balance and hearing may be a factor. It is more common in middle-aged women, but can also appear in men. It is rare in children, adolescents or in people over 70 years of age.
Ménière’s disease is usually manifested by a combination of symptoms:
–Repeated episodes of vertigo (dizziness with a feeling that the surroundings are moving) of variable duration, accompanied by nausea or vomiting, malaise and imbalance
–Noise in the affected ear (tinnitus or tinnitus) which may be constant or may precede the vertigo
–Sensation of pressure in the ear
In general, only one ear is affected, but 25% of patients may develop bilateral Meniere’s over time.
How is Ménière’s disease diagnosed?
The diagnosis of Ménière’s disease is made by the ENT doctor, through a anamnesis directed and a complete ENT exploration that includes ear, nostrils, nasopharynx, oral cavity and larynx.
Subsequently, a specific examination of the vestibular system (of balance) mainly analyzing the movement of the eyes in different directions and speeds, which is altered in disorders of the vestibular system. Other diagnostic tests are several complementary balance and hearing tests (such as caloric tests, vHIT, audiometry, etc.) that are carried out in otoneurology laboratories (subspecialty of ENT that is dedicated to balance disorders).
How is Ménière’s disease treated?
First of all, you must have watch out for salt in the diet and follow a diet with few fluctuations in the amount of salt, rather low in salt, since the pressure of the inner ear fluid is influenced by this and can cause vertigo.
When, despite an adequate diet, the disease is not controlled, medical treatment must be sought. Secondly, there are several medical treatments to control the disease that must be indicated by the ENT doctor, such as betahistine, diuretics, or even injections into the ear.
Treatment must be tailored to each patient. Most patients (approximately 70%) improve with appropriate medical and dietary treatment. When this is not the case, more aggressive treatments are carried out, such as the intratympanic injection of gentamicin, which acts on the cells of the balance of the inner ear. In general, vertigo is controlled in 90% of cases with this method. For the rest of the patients in whom none of the previous treatments have worked, surgery of the affected ear is indicated.