Meniere's disease

Meniere's disease (MD) is an episodic auditory and vestibular disease characterised by sudden onset of vertigo, hearing loss, tinnitus, and sensation of fullness in the affected ear. Earlier in the disease process, all symptoms may not be present.

The cause is unknown, but results in an over-production or impaired absorption of endolymph in the inner ear.

Diagnosis is made on clinical history and detailed audiological tests; other investigations may be required to exclude other causes.

Dietary changes and diuretics may control symptoms in early stages of the disease; specific medical therapies for vertigo control can be tried if required.

If symptoms persist despite maximal medical therapy, several surgical interventions are available.

Meniere's disease or Meniere syndrome is an auditory disease characterised by an episodic sudden onset of vertigo, low-frequency hearing loss (in the early stages of the disorder), low-frequency roaring tinnitus, and sensation of fullness in the affected ear.[1]Goebel JA. 2015 Equilibrium Committee Amendment to the 1995 AAO-HNS guidelines for the definition of Ménière's disease. Otolaryngol Head Neck Surg. 2016 Mar;154(3):403-4. http://www.ncbi.nlm.nih.gov/pubmed/26884364?tool=bestpractice.com ​ Usually the terms are used interchangeably, but MD is commonly used if it is idiopathic and Meniere syndrome if it is secondary to a number of known inner-ear disorders.[2]Thirlwall AS, Kundu S. Diuretics for Ménière's disease or syndrome. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD003599. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003599.pub2/full http://www.ncbi.nlm.nih.gov/pubmed/16856015?tool=bestpractice.com ​ It is also called endolymphatic hydrops, because of the described pathological state observed on post-mortem histological sectioning.[3]da Costa SS, de Sousa LC, Piza MR. Meniere's disease: overview, epidemiology, and natural history. Otolaryngol Clin North Am. 2002 Jun;35(3):455-95. http://www.ncbi.nlm.nih.gov/pubmed/12486835?tool=bestpractice.com [4]Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995 Sep;113(3):181-5.​ It is unclear whether this is a cause of symptoms or a result of the pathological process.