From the Guidelines
Meniere's disease primarily affects low-frequency hearing, with patients typically experiencing fluctuating sensorineural hearing loss that initially impacts the lower frequencies. This is based on the most recent and highest quality study available, which defines Meniere's disease as a clinical condition characterized by spontaneous vertigo attacks with documented low- to midfrequency sensorineural hearing loss in the affected ear 1. The study also notes that the hearing loss in Meniere's disease often fluctuates from low- to mid-frequency but over time may involve all frequencies 1. Key points to consider include:
- The cochlear apex, which detects low-frequency sounds, is particularly vulnerable to the fluid accumulation and pressure changes caused by Meniere's disease.
- Patients often first notice difficulty hearing deep or bass tones while still maintaining relatively normal hearing for higher-pitched sounds.
- As the disease progresses over time, the hearing loss may become more widespread across all frequencies and eventually permanent.
- The goals of Meniere's disease treatment are to prevent or reduce vertigo severity and frequency, relieve or prevent hearing loss, tinnitus, and aural fullness, and improve quality of life 1. Treatment approaches may include modifications of lifestyle factors, medical, surgical, or a combination of therapies, with the choice of treatment considering the hearing status and whether it is usable or not 1.
From the Research
Meniere's Disease and Hearing Loss
- Meniere's disease is characterized by episodes of vertigo, hearing loss, tinnitus, and aural fullness 2, 3, 4, 5.
- The hearing loss associated with Meniere's disease is typically low-frequency at first 2.
- As the disease progresses, the hearing loss can fluctuate and may affect both low and high frequencies, but the initial impact is usually on low-frequency hearing 2, 6.
Frequency of Hearing Loss
- Low-frequency hearing loss is a common symptom of Meniere's disease, and it may be accompanied by tinnitus and aural fullness 2, 6.
- High-frequency hearing loss may also occur in some cases, but it is not typically the primary frequency affected in the early stages of the disease 2.
- The progression of hearing loss in Meniere's disease can be unpredictable, and it may vary from person to person 3, 4, 5.
Diagnosis and Treatment
- Diagnosis of Meniere's disease is made based on a characteristic patient history, including episodes of vertigo, hearing loss, tinnitus, and aural fullness 2, 3, 4, 5.
- Treatment options for Meniere's disease include conservative measures, such as a low-salt diet and avoidance of stress and caffeine, as well as medical therapy with diuretics and intratympanic steroids 2, 3, 4, 5.