Meniere Disease is a condition of the inner ear. For an unknown reason, excess fluid builds up within the inner ear, causing swelling and distention. Meniere Disease classically causes three different inner ear symptoms: vertigo, tinnitus, and hearing loss. Vertigo, or the sensation of the room spinning often accompanied by nausea/vomiting, is due to dysfunction of the balance control mechanism within the inner ear. Many readers guessed our patient had vertigo, but this is a symptom that can be caused by many underlying conditions including Meniere’s, stroke, and benign positional vertigo. Tinnitus is the term for a ringing in the ear. Stretching of the cells in the inner ear inappropriately cause the nerve cells to fire, tricking the brain into thinking it is hearing a noise when there is none.
There are two types of hearing loss: conductive, meaning sound is being blocked from entering the ear, and sensorineural, where the nerves that detect sound are dysfunctional. Hearing loss in Meniere Disease is sensorineural. The first tuning fork test (Rinne) that was performed on our patient demonstrates that the conduction of sound through the air is greater than the conduction of sound through vibrating the bones of the head – this is normal. The second test (Weber) shows that the sound from the tuning fork is quieter on the side with hearing loss, supporting sensorineural deafness. Patients with conductive hearing loss (think wax in the ear) would actually hear the tuning fork louder on the affected side, since ambient noise is blocked out.
Patients are advised to avoid food that can trigger a vertigo attack – commonly salt, caffeine, and alcohol. Dizzy spells are treated with medications, and patients may need hearing aids. Sometimes patients require more extreme therapies, like surgery of the inner ear. Hope you enjoyed learning about Meniere Disease!