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Meniere's disease is a disorder of the inner ear that can affect balance and hearing. It causes vertigo and hearing loss, which can have a big impact on your quality of life.
Its symptoms are the same as those of some other diseases, so it’s often misdiagnosed. To get the right diagnosis and effective treatment, you need an experienced care team.
University of Iowa Health Care’s otology and neurotology specialists have decades of experience with Meniere's disease and other conditions that affect the ears. They have even pioneered treatments for end-stage Meniere's disease.
Meniere's disease symptoms and diagnosis
Most cases of Meniere's disease aren’t traceable to a specific cause. It may result from an ear injury or surgery, autoimmune problems, a viral infection, or an inherited condition.
People who have Meniere's disease report symptoms such as:
- Vertigo: the illusion that you’re moving, or that the room is spinning, when you’re standing still. This vertigo is typically severe, causes nausea and vomiting, and can last from 20 minutes to 24 hours.
- Changes in hearing
- Ringing in one ear (tinnitus)
- A feeling of pressure in one or both ears
How Meniere's disease is diagnosed
After a thorough physical examination, you’ll likely have a hearing test (audiogram). Based on those results, you may need other tests, including:
- Magnetic resonance imaging (MRI)
- A videonystagmography (VNG), also referred to as an electronystagmography (ENG). This noninvasive test measures your involuntary eye movements while you wear a special pair of goggles.
Your specialist may also have you evaluated by a neurologist in the UI Health Care balance disorders clinic. This will rule out migraines or other neurological conditions that can cause vertigo.
Our team members work together to make sure you get the right diagnosis and the most effective treatment.
Meniere's disease treatment from UI Health Care
The exact cause of Meniere's disease isn’t clear. Its symptoms are caused by too much fluid in the inner ear, or labyrinth.
This excess fluid interferes with the balance and hearing signals that the inner ear sends to the brain, resulting in vertigo and hearing loss.
For most people, diet changes and medication can reduce the number and severity of vertigo attacks. If these tactics don’t work, surgery may be an option.
Diet and physical therapy
A low-sodium diet, combined with medication to reduce fluid in the inner ear, can be an effective treatment for the vertigo caused by Meniere's disease.
Some people report that drinking caffeine or alcohol makes their symptoms worse. If you consume one or both, try avoiding them for a few weeks to see if you notice an improvement.
Specialized physical therapy, called vestibular rehabilitation, is sometimes prescribed to help with balance. UI Health Care physical therapists have extensive training and experience in vestibular rehabilitation.
In addition to a low-sodium diet, your specialist might prescribe:
- Diuretics, or water pills
- Steroids, such as prednisone, for short-term use
- Vestibular suppressants such as diazepam. These medications relieve symptoms of vertigo temporarily.
If diet and medication aren’t effective against your symptoms, your team may recommend surgery. They will consider factors like how well you hear, the amount of balance function remaining in both ears, your age, and your overall health.
The UI Health Care team offers more surgical options than any other system in the Midwest.
Conservative procedures to adjust fluid levels in the inner ear include:
- Endolymphatic sac surgery, which places a shunt, or tube, to drain fluid from the inner ear
- Intratympanic steroid injection, which places steroids into the ear
If these procedures don’t work for you, your team may recommend a more aggressive approach. The following procedures destroy certain tissues that control your balance. Your brain will compensate by using the balance controls in your other ear.
- Vestibular nerve sectioning, a microsurgery that requires making an opening in the skull. Your neurotologist will cut the nerve that controls your balance while carefully preserving the nerves that control your hearing and your facial muscles. Our team has unmatched expertise with this delicate procedure.
- Labyrinthectomy, which removes the balance center of the inner ear. This surgery may be recommended if you have severe vertigo and poor hearing. Your neurotologist might be able to place a cochlear implant during surgery, which will help restore hearing to the affected ear. The UI Health Care neurotology team has more experience with this procedure than anyone else in the Midwest.
- Gentamicin chemical labyrinthectomy, using an antibiotic that is toxic to balance cells in the inner ear. The drug is injected through the eardrum using a small needle. The procedure is performed in your neurotologist’s office and may need to be repeated two to three times. If you’re too sick to have surgery or you have poor hearing, this may be an option for you.
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