From the Guidelines
The exact cause of Meniere's disease remains unknown, though it's believed to result from abnormal fluid buildup in the inner ear, as stated in the clinical practice guideline by 1. This condition, called endolymphatic hydrops, disrupts the balance and hearing signals sent to the brain. Several factors may contribute to this fluid imbalance, including autoimmune responses, viral infections, genetic predisposition, and circulatory problems that affect the inner ear. Some research suggests that Meniere's disease might involve a combination of these factors rather than a single cause. The abnormal fluid accumulation creates increased pressure within the endolymphatic system of the inner ear, damaging the delicate sensory cells responsible for balance and hearing. This damage leads to the characteristic symptoms of Meniere's disease: vertigo (spinning sensation), fluctuating hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear. While we cannot currently prevent Meniere's disease due to its unclear cause, treatments focus on managing symptoms and reducing fluid buildup in the inner ear, as outlined in the clinical practice guideline by 1. Key points to consider in the management of Meniere's disease include:
- Diet restrictions, such as a low-sodium diet, to help decrease symptoms
- Limiting alcohol and caffeine intake
- Medications, such as diuretics and antivertigo medications, to reduce symptoms
- Noninvasive therapies, including vestibular rehabilitation and hearing aids
- Surgical options, such as endolymphatic sac decompression and vestibular nerve section, for more severe cases. It is essential to work with a healthcare provider to determine the best course of treatment and to regularly monitor symptoms to improve quality of life, as suggested by 1.
From the Research
Cause of Meniere's Disease
The cause of Meniere's disease is not fully understood, but several factors are believed to contribute to its development. These include:
- Genetics: Epidemiologic and genomic evidence supports a genetic susceptibility to Meniere's disease 2
- Autoimmunity: Recent studies suggest that immune mechanisms may play a role in the disease 3
- Infection: Infectious agents may trigger Meniere's disease by modifying inner-ear homeostasis 2
- Trauma: Trauma to the inner ear may contribute to the development of Meniere's disease 4
- Allergy: Allergens may also trigger Meniere's disease by modifying inner-ear homeostasis 2
- Endolymphatic Hydrops (ELH): A key histopathological feature of Meniere's disease, characterized by the excessive buildup of endolymph fluid in the membranous labyrinth of the inner ear 4, 5, 6
Biological and Bioenvironmental Factors
Biological and bioenvironmental factors, such as:
- Endocrine system: Multiple biochemical pathways involved, including the endocrine system 2
- Innate immune response: Innate immune response may play a role in the development of Meniere's disease 2
- Autonomic nervous system: Autonomic nervous system may also be involved in the disease 2
- Vascular events: Vascular events may trigger Meniere's disease by modifying inner-ear homeostasis 2
Other Theories
Other theories, such as:
- Saccular otoconia blocking the endolymphatic duct and sac: A new theory that may contribute to the development of Meniere's disease 4
- Membranous ruptures: Pressure and mechanical displacement of the end organs, or obstruction followed by an abrupt clearance of the endolymphatic duct may also play a role in the disease 6