A Basic Overview of Meniere's Disease,
Also Known as Endolymphatic Hydrops
The National Institute on Deafness and Other Communication
What Is Meniere's Disease?
Meniere's Disease is an abnormality of the inner ear causing a
host of symptoms, including vertigo or
tinnitus or a roaring sound in the ears,
loss, and the sensation of pressure or pain in the affected ear.
The disorder usually affects only one ear and is a common
cause of hearing loss. Named after French physician Prosper Ménière who first described the syndrome in 1861, Meniere's
Disease is now also referred to as endolymphatic hydrops.
What Causes Meniere's Disease?
The symptoms of Meniere's Disease are associated with a change
in fluid volume within a portion of the inner ear known as the
labyrinth. The labyrinth has two parts: the bony labyrinth and
the membranous labyrinth. The membranous labyrinth, which is
encased by bone, is necessary for hearing
and balance and is filled with a fluid called endolymph.
your head moves, endolymph moves, causing nerve receptors in the
membranous labyrinth to send signals to the brain about the
body's motion. An increase in endolymph, however, can cause the
membranous labyrinth to balloon or dilate, a condition known as
Many experts on Meniere's Disease think that a rupture of the
membranous labyrinth allows the endolymph to mix with perilymph,
another inner ear fluid that occupies the space between the
membranous labyrinth and the bony inner ear. This mixing,
scientists believe, can cause the symptoms of Meniere's Disease.
Scientists are investigating several possible causes of the
disease, including environmental factors, such as noise
pollution and viral infections, as well as biological factors.
What Are the Symptoms of Meniere's Disease?
The symptoms of Meniere's Disease occur suddenly and can arise
daily or as infrequently as once a year. Vertigo, often the most
debilitating symptom of Meniere's Disease, forces the sufferer
to lie down. Vertigo attacks can lead to severe nausea,
vomiting, and sweating and often come with little or no warning.
Some individuals with Meniere's Disease have attacks that start
with tinnitus, a loss of hearing, or a full feeling or pressure
in the affected ear. It is important to remember that all of
these symptoms are unpredictable. Typically, the attack is
characterized by a combination of vertigo, tinnitus and hearing
loss lasting several hours. But people experience these
discomforts at varying frequencies, durations, and intensities.
Some may feel slight vertigo a few times a year. Others may be
occasionally disturbed by intense, uncontrollable tinnitus while
sleeping. And other Meniere's Disease sufferers may notice a
hearing loss and feel unsteady all day long for prolonged
periods. Other occasional symptoms of Meniere's Disease include
headaches, abdominal discomfort and diarrhea. A person's hearing
tends to recover between attacks but over time becomes worse.
How Is Meniere's Disease Treated?
There is no cure for Meniere's Disease. Medical and behavioral
therapy, however, are often helpful in managing its symptoms.
Although many operations have been developed to reverse the
disease process, their value has been difficult to establish.
And, unfortunately, all operations on the ear carry a risk of
The most commonly performed surgical treatment for Meniere's Disease is the insertion of a shunt, a tiny silicone tube that
is positioned in the inner ear to drain off excess fluid.
In another more reliable operation, a vestibular neurectomy, the
vestibular nerve which serves balance is severed so that it no
longer sends distorted messages to the brain. But the balance
nerve is very close to the hearing and facial nerves. Thus, the
risk of affecting a patient's hearing or facial muscle control
increases with this type of surgical treatment. Also, older
patients often have difficulty recovering from this type of
A labyrinthectomy, the removal of the membranous labyrinth, is
an irreversible procedure that is often successful in
eliminating the dizziness associated with Meniere's Disease.
This procedure, however, results in a total loss of hearing in
the operated ear -- an important consideration since the second
ear may one day be affected. Also, labyrinthectomies themselves
may result in other balance problems.
Some physicians recommend a change of diet to help control Meniere's symptoms. Eliminating caffeine, alcohol and salt may
relieve the frequency and intensity of attacks in some people.
Eliminating tobacco use and reducing stress levels may lessen
the severity of the symptoms. And medications that either
control allergies, reduce fluid retention or improve blood
circulation in the inner ear may also help.
How Is Meniere's Disease Diagnosed?
Scientists estimate that there are 3 to 5 million people in the
United States with Meniere's Disease, with nearly 100,000 new
cases diagnosed each year. Proper diagnosis of Meniere's Disease
entails several procedures, including a medical-history
interview and a physical examination by a physician; hearing and
balance tests; and medical imaging with magnetic resonance
imaging (MRI). Accurate measurement and characterization of
hearing loss are of critical importance in the diagnosis of Meniere's Disease.
Through the use of several types of hearing tests, physicians
can characterize hearing loss as being sensory, arising from the
inner ear, or neural arising from the hearing nerve. An auditory
brain stem response, which measures electrical activity in the
hearing nerve and brain stem, is useful in differentiating
between these two types of hearing loss. And under certain
circumstances, electrocochleography, recording the electrical
activity of the inner ear in response to sound, helps confirm
To test the vestibular or balance system, physicians irrigate
the ears with warm and cool water. This flooding of the ears,
known as caloric testing, results in nystagmus, rapid eye
movements that can help a physician analyze a balance disorder.
And because tumor growth can produce symptoms similar to Meniere's Disease, magnetic resonance imaging is a useful test
to determine whether a tumor is causing the patients vertigo and
What Research Is Being Done?
Scientists are investigating environmental and biological
factors that may cause Meniere's Disease or induce an attack.
They are also studying how fluid composition and movement in the
labyrinth affect hearing and balance. And by studying hair cells
in the inner ear, which are responsible for proper hearing and
balance, scientists are learning how the ear converts the
mechanical energy of sound waves and motion into nerve impulses.
Insights into the mechanisms of Meniere's Disease will enable
scientists to develop preventive strategies and more effective
Where Can I Get Additional Information?
The NIDCD currently supports research on Meniere's Disease in
medical centers and universities throughout the nation. For more
information about Meniere's Disease, you can contact:
American Academy of Otolaryngology-Head and Neck Surgery
One Prince Street
Alexandria, VA 22314
Voice: (703) 519-1589
TTY: (703) 519-1585
Deafness Research Foundation
575 5th Avenue, 11th Floor
New York, NY 10017
Voice: (800) 535-DEAF
TTY: (212) 599-0027
1817 Patterson Street
Nashville, TN 37203
Voice: (615) 329-7807
Voice: (800) 545-HEAR
TTY: (615) 329-7849
Vestibular Disorders Association
P.O. Box 4467
Portland, OR 97208-4467
Voice: (503) 229-7706
Voice: (800) 837-8428
"The National Institute on Deafness and Other Communication
Disorders of The National Institutes of Health. NIDCD Publication: Because
You Asked about Meniere's Disease.
By Karin Henderson - Nurse, Retired.
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