Signs of Meniere’s Disease

Woman wearing hearing aid - Meniere’s Disease

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Its name is tricky to pronounce, its arrival is signaled by vertigo and tinnitus and, as it progresses, its presence tends to worsen with hearing loss, imbalance and the sensation of internal ear pressure.

It is known as Ménière’s disease, one of the lesser chronic disorders but a condition that can lead to complete hearing loss in one or both ears.

“Ménière’s disease is considered treatable but not curable and, in most cases, affects only one ear,” said Dr. Kathryn Miles Jackson, doctor of audiology and owner of Upstate Hearing & Balance in Greenville. “It can occur at any age but usually starts between young and middle-aged adulthood, and attacks can be brought on by certain triggers, such as dietary factors.”

Patients with suspected Ménière’s disease are encouraged to keep a food diary because items such as caffeine, chocolate and alcohol can induce attacks. But diet is only one part of the puzzle.

Fluid retention, which produces a buildup of pressure in one of the spaces in the inner ear, is thought to be the cause of Ménière’s disease. Consumption of too much sodium can cause an accumulation of fluid in the body. And although there is no sodium recommendation specifically for patients with Ménière’s, following the American Heart Association’s ideal limitation of 1,500 mg a day may be helpful to manage attacks.

Stress also plays a part in the onset of the disease, as does the sudden feeling of vertigo – which makes you feel like you’re spinning, dizzy and lightheaded with a loss of balance – plus a condition known as tinnitus.

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“Tinnitus is a buzzing or ringing in the ears,” Dr. Jackson said. “Patients with Ménière’s disease often describe this sensation as a rushing or roaring sound.”

Some treatments aren’t particularly attractive. For example, an injection of an antibiotic medication, gentamicin, into the middle ear reduces the effectiveness of the balance organ for that ear, alleviating vertigo attacks but possibly making the hearing loss even worse.

“But the patient may find benefit for hearing using either a hearing aid or a cochlear implant once the disease has run its course,” Dr. Jackson said.

Alternatively, a steroid, such as dexamethasone, may be injected into the middle ear space to help control vertigo attacks.

“It is considered less effective than gentamicin but is less likely to cause further hearing loss,” Dr. Jackson said. “When these treatments don’t help, surgical options might be considered, such as endolymphatic sac decompression, labyrinthectomy or vestibular nerve section.”

If you experience any symptoms of Ménière’s – pronounced Main-yerrz – the first step toward determining if you have it and a best course of action starts with an ear examination by a qualified audiologist and an ear, nose and throat specialist.

Assessments should begin with a basic test of your hearing and your balance.

And, along the way, your audiologist and ENT physician should keep you informed about all of your options.

“I educate my patients so that they understand the diagnostic and treatment process at every step of their testing,” said Dr. Jackson, who is certified by the American Board of Audiology. “And I care for patients of all ages and conditions.”

The National Institute on Deafness and Other Communication Disorders estimates that approximately 615,000 individuals in the United States are currently diagnosed with Ménière’s disease and that 45,500 new cases are diagnosed each year.

As disorders go, it is relatively rare, affecting only about 0.2% of the U.S. population or 1 in every 500. About 60% of those affected either get better on their own or are able to manage their symptoms with diet or medications.

But Dr. Jackson said that if the disease itself causes significant destruction to the balance organ of the affected ear, patients experiencing imbalance can benefit from vestibular rehabilitation therapy.

“This kind of therapy is designed by a specially-trained vestibular physical therapist and works to improve balance and reduce problems related to dizziness,” she said. “The exercises help retrain your brain to integrate the cues and signals from your entire balance system. Working closely with an audiologist and an ENT can greatly improve the quality of life for people with Ménière’s disease. And although it isn’t curable, management of the disease along with prevention strategies and applicable treatment provide hope.”

Dr. Kathryn Jackson of Upstate Hearing & Balance prepares a patient for hearing aid programming using “real ear” or probe microphone measures.
Dr. Kathryn Jackson of Upstate Hearing & Balance prepares a patient for hearing aid programming using “real ear” or probe microphone measures.


By L. C. Leach III


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