Meniere’s Disease

A rare inner ear condition like Meniere’s disease can sometimes generate more questions for you than available solutions and treatments.

But at The Ohio State University Wexner Medical Center, if you receive a diagnosis of Meniere’s disease, several experts will be available for your treatment. In fact, we are home to many of the state’s neurotologists who specialize in diagnosing and treating complex ear, nose and throat (ENT) conditions, such as this one.

Additionally, the Department of Otolaryngology – Head and Neck Surgery is ranked as one of the best ENT programs in the country by U.S. News & World Report, and many doctors in Columbus, Ohio, and the region refer their patients with balance-related or hearing loss symptoms to us for evaluation. You will be among specialists with access to the latest techniques for diagnosis and treatment of Meniere’s disease.

What is Meniere’s disease?

Despite its name, Meniere’s disease is actually a cluster of symptoms, including vertigo and hearing loss, for which an underlying cause is not exactly known. These symptoms affect the inner ear, including a person’s balance and hearing.

The symptoms related to Meniere’s disease occur because of an abnormality with the fluid in your inner ear — either the amount of the fluid or the composition of the fluid. We don’t always know why people develop this condition, but it’s been known to run in families, meaning it could be genetic. Other possible causes of the fluid buildup include:

• Abnormal immune responses
• Head trauma
• Migraines

It usually only affects one ear; however, over time, some people can develop Meniere’s in both ears, usually many years apart.

Roughly 615,000 people in the United States live with this disease, which typically affects people between 40 and 60 years of age.

Meniere’s disease symptoms

Symptoms of Meniere’s disease involve the inner ear, especially how it affects hearing and the body’s physical balance. Signs of the condition include:

• Ringing in one or both ears, also known as tinnitus 
• Fluctuating hearing loss in one ear that may become more permanent
• Ear pressure or pain, also known as aural fullness
• Bouts of dizziness or vertigo
• Nausea or vomiting during vertigo episodes
• Balance issues

The attacks of dizziness may come on suddenly or after a short bout of tinnitus or muffled hearing. You may even notice ear pressure or a drop in hearing in the hours before the vertigo starts. These vertigo episodes can last 20 minutes to several hours. Some people experience only an occasional attack, while others have many episodes close together over several days.

Some people have what are called sudden drop-attack falls — vertigo episodes where the dizziness is so bad, they lose their balance and fall without warning. This is also known as spells of Tumarkin. After any type of vertigo episode, you may feel off-balance for several days, even after the most severe symptoms have passed.

Diagnosis of Meniere’s disease

The Department of Otolaryngology – Head and Neck Surgery at the Ohio State Wexner Medical Center has a dedicated staff that performs the most advanced testing, which helps ensure you are properly diagnosed so that your treatment can be as effective as possible, and you can return to health faster.

There is no definitive test for Meniere’s disease. Instead, our audiologists and ENT physicians will investigate the pattern of your symptoms, including multiple vertigo episodes and hearing loss. We’ll use a combination of other evaluations to make a definitive diagnosis. Those tests include:

• Hearing tests – These are performed by trained audiologists.
• Dynamic vestibular testing – This could include an electronystagmogram or videonystagmography (ENG or VNG), both of which observe eye movements and brain function as they relate to balance.
• Positional testing of semicircular canals – This test examines how the eye jumps when the head is moved in different positions, such as side to side.
• Caloric reflex (stimulation) tests – We can test for a weakened inner ear by placing cold or warm air or water into the ear canal and seeing how it responds.
• Magnetic resonance imaging (MRI) or CT scans – These noninvasive imaging tests create detailed pictures of the body to rule out other conditions that could cause similar symptoms.

Meniere’s disease treatment

Treatment of each patient with Meniere’s disease will vary. If you receive a Meniere’s disease diagnosis, your ENT will work closely with you to determine the best course for your condition and needs.

While there is no cure for Meniere’s disease and it never goes away completely, we have several treatment options that range from lifestyle changes to medications to surgery. We focus first on all noninvasive options before resorting to surgical procedures. Treatment we use include:

• Diet changes – Limiting salt helps improve the condition in 80% of people.
• Drug therapy – You might be put on diuretic medications, which can help with vertigo and other symptoms.
• Hearing aids – These can help with any hearing loss you experience because of the disease.
• Steroid injections – These can help control vertigo attacks.
• Antibiotic injections – We can inject an antibiotic called gentamicin into the inner ear balance organ. This can be a very effective treatment, but it can cause hearing loss in some cases.
• Surgery – More invasive procedures, such as endolymphatic sac decompression or a shunt, and labyrinthectomy, are performed in more severe cases.