Meniere’s disease in Tampa and Spring Hill, FL
Dizziness, vertigo, fatigue and hearing loss may be related to Meniere’s disease, a condition that may affect one or both ears. Because Meniere’s disease has such a significant impact on quality of life, Suncoast ENT Surgical Specialists offers advanced treatments for the condition. Our board-certified Otolaryngologist/Head and Neck Surgeons have helped hundreds of people in Tampa, Spring Hill and nearby areas in Florida overcome the effects of Meniere’s disease.
What is Meniere’s disease?
Meniere’s disease, which is also known as idiopathic endolymphatic hydrops, is a disorder affecting the inner ear. While the cause of the disease is unknown, an abnormality of the inner ear fluids is the most likely reason. The disorder is among the most common culprits for dizziness caused by inner ear problems.
A single ear is involved in many instances, but in around 15% of cases, the problem involves both ears. Meniere’s disease normally occurs in people between 20 and 50 years of age, and the risk is similar for men and women.
What Are The Symptoms?
Meniere’s disease typically involves tinnitus (ringing or other loud noises in the ears), episodic rotational vertigo (random bouts of spinning vision), hearing loss and full feelings in the ear. Out of all the symptoms of Meniere’s disease, vertigo is often the worst. Vertigo involves feeling like you’re moving when you’re not.
Meniere’s disease is most often caused by inner ear dysfunction, but disorders of the nervous system may also be a factor. In Meniere’s disease, vertigo occurs as random attacks of feeling like the room is spinning and may also include dysequilibrium (feeling off-balance), nausea and vomiting. The episodes can last anywhere from 20 minutes up to two hours or longer. While the attacks are occurring, sufferers find it difficult or impossible to perform routine tasks such as housework, their job, driving or even walking.
After the attack, patients may experience several hours of fatigue, and the dysequilibrium can continue for days.
In some cases, periodic hearing loss can occur in the disease’s early stage, particularly with lower-pitch sounds. However, fixed hearing loss will develop eventually, which affects the ability to hear tones of any pitch. Discomfort from loud noises may also occur in the afflicted ear.
The other symptoms of Meniere’s disease, fullness and tinnitus, can disappear and reappear with changes in hearing, happen prior to or during vertigo attacks or be consistent.
Symptoms of Meniere’s disease can be mild enough to be only a minor disruption, or may be troublesome enough to dictate your life, especially if the episodes of vertigo are severe, frequent and unexpected.
How Is A Diagnosis Made?
Your doctor notes the frequency, length, severity and nature of episodes. Other significant medical information includes how long hearing loss lasts, changes in symptoms and the sensation of fullness or tinnitus in one or both ears. The doctor may also ask if you have a history of serious infections such as mumps, syphilis or measles, eye inflammation, allergies, autoimmune diseases or ear surgery.
You might also receive questions regarding your overall health, such as if you have hypertension (high blood pressure), diabetes or high cholesterol, and whether you have any thyroid, neurological or psychological problems. Tests may be performed to rule out these disorders. In most cases, physical exams of the ears, head, neck, and throat divulge nothing unless an attack is in progress.
An audiometric exam, or hearing test, can often determine if sensory type hearing loss is present. The ability to hear the difference between words such as “fit” and “sit”, called speech discrimination, is typically reduced in the afflicted ear.
Your doctor may do an electronystagmogram (ENG) to determine your degree of balance. The ENG is usually performed in a dark room and eye movements recorded. Cool or warm air or water is put into each ear. Because the ears and eyes function in tandem through the central nervous system, recording eye movements allows your doctor to measure your level of balance. The balance function of the afflicted ear is hindered in roughly half of cases. Other means of measuring balance, such as balance platforms or rotational testing, might also be used.
Other tests may also be recommended by our ENT specialists. An electrocochleography (EcoG) can cause increases in the pressure of the inner ear fluid in some patients. A computerized method for testing of the auditory nerves and brain pathways, called auditory brainstem response (ABR), CT scan or MRI may be required to eliminate the possibility of a tumor on the nerve controlling hearing and balance. Although these are a rare occurrence, they can mimic the symptoms of Meniere’s disease.
What Treatment Will The Physician Recommend?
- Medications and diet changes: Minimizing dietary sodium and taking a diuretic can help decrease the frequency of attacks for some people. To ensure that the diuretic has an optimal effect, you should keep sodium intake low and use your medication as directed by your doctor. Anti-dizziness medications such as diazepam (Valium) or meclizine (Antivert) can temporarily relieve vertigo symptoms. In some cases, an anti-emetic (anti-nausea) drug may also be prescribed. Please note, though, that these medications can cause sleepiness.
- Lifestyle changes: Avoid using substances such as alcohol, caffeine and nicotine. Maintain a healthy, nutritious diet and make sure you get plenty of sleep. Stress is known to worsen the tinnitus and vertigo that occur with Meniere’s disease. If you struggle with stress, counseling or avoidance may be recommended.
- Preventative action: If your vertigo attacks occur suddenly and unexpectedly, you should avoid driving or operating heavy machinery. Accidents may cause injuries to yourself or others. You may also need to avoid things such as swimming, bicycling and using scaffolding or ladders.
When Is Surgery Recommended?
If your vertigo does not respond to conventional treatments and is debilitating, the ENT specialist may recommend surgery.
- The decompression procedure, also called an endolymphatic shunt, is used to preserve hearing in Meniere’s disease. In 50% to 66% of cases, vertigo attacks are minimized, but this won’t last in every case. Compared to other surgeries, this has a short recovery time.
- A selective vestibular neurectomy involves cutting the balance nerve where it exits the inner ear and connects to the brain. In many cases, vertigo attacks are completely resolved, and hearing may also be preserved.
- Labyrinthectomy and eighth nerve section are surgeries that destroy the inner ear mechanisms controlling hearing and balance on one side. This is taken into consideration with patients experiencing hearing loss in the afflicted ear. These surgeries provide the best rates of controlling vertigo attacks in Meniere’s disease.
In certain cases, other treatments or surgeries may be recommended. If surgery becomes a necessity, it’s important to discuss the benefits and risks with your doctor. While Meniere’s disease has no known cure, almost all cases of related vertigo attacks can be controlled.
The exact cause of Meniere’s disease is not known, and some patients are misdiagnosed by general practitioners. The ENT physicians of Suncoast ENT Surgical Specialists are experts in the diagnosis and treatment of Meniere’s disease. Contact our office in Tampa or Spring Hill to schedule a consultation to determine if your symptoms are associated with Meniere’s disease.