From the Guidelines
Ménière's disease is characterized by four main symptoms: episodic vertigo, fluctuating hearing loss, tinnitus, and aural fullness, which can significantly impact a patient's quality of life. These symptoms occur due to excess fluid (endolymph) in the inner ear, disrupting balance and hearing functions 1. The symptoms of Ménière's disease can be managed with a combination of lifestyle modifications, medical therapies, and surgical interventions.
Symptoms and Diagnosis
The symptoms of Ménière's disease include:
- Episodic vertigo, lasting from 20 minutes to several hours
- Fluctuating hearing loss, initially affecting low frequencies
- Tinnitus, manifesting as ringing, roaring, or buzzing in the affected ear
- Aural fullness, creating a sensation of pressure or congestion in the ear Diagnosis is based on a combination of clinical presentation, audiometric testing, and imaging studies, although physical examination findings are often unremarkable and conventional imaging is typically normal 1.
Management and Treatment
Management of Ménière's disease focuses on reducing vertigo severity and frequency, relieving hearing loss, tinnitus, and aural fullness, and improving quality of life. Treatment approaches include:
- Lifestyle modifications: dietary sodium restriction (1500-2000mg daily), limiting alcohol and caffeine intake, and avoiding tobacco
- Medical therapies: diuretics such as hydrochlorothiazide (25-50mg daily), antivertigo medications, and betahistine
- Non-invasive therapies: vestibular rehabilitation, hearing aids, and middle ear injections
- Surgical interventions: endolymphatic sac decompression, vestibular nerve section, and labyrinthectomy 1.
Quality of Life and Support
Ménière's disease can significantly impact a patient's quality of life, causing feelings of sickness, tiredness, and anxiety. Regular follow-up with a healthcare provider is essential to manage symptoms and improve quality of life. Patients can also benefit from joining support groups and accessing educational resources, such as the Vestibular Disorders Association and the Ménière's Society 1. A comprehensive treatment plan, including lifestyle modifications, medical therapies, and support, can help alleviate symptoms and improve quality of life for patients with Ménière's disease.
From the Research
Ménière's Disease Symptoms
Ménière's disease is a condition that causes recurrent episodes of vertigo, associated with hearing loss and tinnitus 2. The symptoms of Ménière's disease include:
- Ear fullness
- Tinnitus
- Fluctuant sensorineural hearing loss
- Vertigo 3, 4, 5 These symptoms can be debilitating and affect a person's quality of life.
Treatment and Management
The treatment and management of Ménière's disease involve lifestyle changes, dietary modifications, and medications. Some of the recommended lifestyle changes and dietary modifications include:
- Low-sodium diet
- Reduction in daily alcohol and caffeine intake
- Gluten-free diet
- Specially processed grains 2, 3, 4, 5 Medications such as betahistine, steroids, and intratympanic gentamicin may also be used to manage the symptoms of Ménière's disease 4, 5, 6.
Vertigo Management
Vertigo is often the most debilitating symptom associated with Ménière's disease. The management of vertigo may involve intratympanic injection of gentamicin, which can be beneficial in reducing vestibular function and controlling vertigo 4. Other treatment options for vertigo include lifestyle changes, medications, and ablative therapy applied to the diseased ear 5.