ABOUT THE CONDITION
What is Ménière’s disease?
Ménière’s disease is a condition that affects the inner ear, which controls your hearing and balance. The exact cause is not known. It is thought to occur due to an abnormal build-up of fluid in the inner ear. This can affect the ear’s ability to send signals to the brain about balance and sound.
Possible factors that can contribute to Ménière’s include:
- Genetic predisposition (it can run in families).
- Abnormal immune responses.
- Infections caused by viruses.
- Stress or allergies.
What symptoms can Ménière’s cause?
Symptoms of Ménière’s disease can be different from person to person. They often occur in episodes and include:
- Dizziness or vertigo
- A spinning sensation that can last from minutes to several hours.
- May cause nausea or vomiting.
- Hearing Loss
- Your hearing might get worse then better (fluctuate) during an episode. The hearing tends to recover between episodes.
- Over time, your hearing loss gets worse and may become permanent.
- Tinnitus
- A ringing, buzzing, or hissing sound in the affected ear.
- Ear fullness
- A feeling of pressure or fullness in the ear.
These symptoms can occur on their own or together. Episodes may change in frequency and severity.
How is Ménière’s diagnosed?
There is no single test for Ménière’s disease. Diagnosis is based on your symptoms, medical history, and results from tests to rule out other conditions.
Common tests include:
- Hearing tests: To assess hearing loss.
- Balance tests: To check the function of the inner ear.
- MRI or CT scans: To exclude other causes of dizziness or vertigo and of hearing loss, such as a benign swelling of the nerve of balance or degenerative conditions such as multiple sclerosis.
ABOUT THE TREATMENT
How is Ménière’s treated?
Although there is no cure for Ménière’s disease, treatments can help manage symptoms and improve quality of life.
Lifestyle changes
- Diet: Reducing salt, caffeine, alcohol, and foods containing Monosodium Glutamate (MSG) may help decrease fluid build-up in the inner ear.
- Stress management: Relaxation techniques like yoga, mindfulness, or therapy can help.
Medications
- Diuretics: Water pills that may help reduce inner ear fluid build-up.
- Betahistine: A tablet which works by increasing the effect of a natural substance called histamine in your inner ear. It can reduce the frequency and severity of vertigo attacks.
- Antiemetics: These are anti-sickness medications which can help control nausea and vomiting during an episode.
- Vestibular sedatives: Help reduce symptoms of dizziness or vertigo.
- Steroids: Taken by mouth or injected into the middle ear to reduce inflammation and dizziness or vertigo.
- Gentamicin: An antibiotic injected into the ear to stop inner ear function if your hearing is already very poor.
Other treatments
- Vestibular Rehabilitation Therapy (VRT): Personalised balance exercises which can help improve stability, especially in the later stages.
- Hearing aids: Useful for managing hearing loss.
- Meniett device: A small device that delivers gentle air pressure pulses to the ear, which may reduce dizziness or vertigo.
Surgical treatments
For severe cases where symptoms don’t respond to other treatments:
- Grommets: Tiny tubes placed across the eardrum to relieve pressure. A short-term grommet is usually inserted first. This tends to fall out within 6 to 9 months. A long-term grommet can be placed if this works for you. This is the least invasive form of surgery.
- Endolymphatic sac surgery: Reduces fluid build-up in the ear.
- Vestibular nerve section: Cuts the nerve of balance to stop dizziness or vertigo while preserving hearing.
Labyrinthectomy: Removes the balance part of the inner ear, only done when a patient’s hearing is already very poor.
Important safety points
- Vertigo medication: Always carry medication to manage sudden attacks.
- Avoid risky activities: Don’t climb ladders, swim alone, or engage in activities where sudden dizziness or vertigo could cause harm.
- Home safety: Prevent falls by blocking access to stairs and removing tripping hazards.
- Driving: Stop driving if you’re diagnosed with Ménière’s disease. You must inform the DVLA. You can start driving again once your symptoms are under control.
Living with Ménière’s disease
Living with Ménière’s disease can be challenging, but many people lead full, active lives with proper treatment and lifestyle adjustments.
- Work with your healthcare team: Develop a personalised plan for managing your symptoms.
- Support groups: Connecting with others can help you cope emotionally and share practical advice.
Further reading
For more information and support:
Disclaimer: This publication is intended for patient information. While every effort has been made to ensure accuracy, the information provided may not be complete, and patients should consult a healthcare professional before taking any action based on it.