Pathology

The Relationship between Menieres Disease and Deafness



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Meniere’s disease is a debilitating condition of the inner ear that can cause tinnitus, severe imbalance, vertigo, pressure inside the ear and hearing loss. Hearing loss can fluctuate and tends to affect the sufferer more on some days than others. Hearing loss associated with this disease can also lead to permanent hearing loss in the affected ear.

What affect does Meniere’s disease have on the ears?

The ear has two main functions: To capture sounds and relay them to the brain so that they can be interpreted and to keep the body balanced. People who suffer from Meniere’s disease live in an uncertain world, as their state of balance is compromised due to a build-up of fluid in the inner ear (also known as the labyrinth). The labyrinth houses the organs of balance, which are the semi-circular canals and the otolithic organs, along with the hearing organ which is called the cochlea. The fluid (endolymph) in the semi-circular canals of the inner ear moves around every time the head is moved, and this enables nerve receptors in the membranous labyrinth to send messages to the brain about the body’s movement and position.  In the cochlea, however, the fluid is compressed when sound vibrations are detected and this tells the sensory cells to send signals to the brain.  If there is an increase in fluid, this interferes with the normal balance of the body and the hearing signals that go between the inner ear and the brain – thus causing unpleasant side effects.   

Sufferers of Meniere’s don’t always experience all the common symptoms of the disease, but when any symptoms do occur it is known as an “attack”. They don’t always know when an attack is going to take place, but once one occurs it can last anything from several minutes to several hours. Some attacks can bring on such severe bouts of vertigo that the person can lose their balance altogether and fall over – these are known as “drop attacks”. Attacks can often leave the sufferer feeling exhausted and in need of a long rest. The on-going symptoms of Meniere’s disease can also have a huge impact on the person’s life, and without adequate support it can sometimes lead to bouts of depression.     

Who gets Meniere’s disease and why?

Meniere’s disease was first described by a French doctor by the name of Prosper Ménière in the 1860s. The disease can affect people of any age, but tends to target mainly adults between the ages of 40 and 60. It usually affects only one ear, although in some cases it can affect both ears. No one knows exactly what causes the disease, but researchers have their own theories. Some think that it may be caused by constricting blood vessels or a blockage in the endolymphatic duct or sac. Others think that it could be linked to viral infections, allergies, or even genetics, as the disease appears to run in families. There are also some scientists who believe that there is some relationship between Meniere’s disease and migraine.  

How is Meniere’s disease diagnosed?

There is no precise test for Meniere’s disease, but a number of tests are usually carried out on patients who appear to haves symptoms of the disease to rule out any other illnesses. A hearing test is then usually carried out to establish the extent of hearing loss. Other than this, diagnosis of the condition is made purely on the set of symptoms that are presented to the doctor.  

Does Meniere’s disease cause any permanent damage?

Meniere’s disease can kill the hair cells in the inner ear - the cochlea cells are very sensitive. After many years of having the condition, the patient may develop develop unilateral functional deafness. Mechanical distortion and disruption of the inner ear structure may eventually cause the patient to become very unsteady on their feet, even when they are not having an attack.

Is there a cure for Meniere’s disease?

There is as yet no cure for Meniere’s disease and most treatments are purely used to reduce the severity and frequency of the symptoms. Treatment consists of:

Diet – it is important to eat a healthy diet that includes plenty of fresh fruits and vegetables, and to reduce salt intake and foods that have high sodium and monosodium glutamate levels. Reducing your salt intake will help to decrease fluid accumulation in the inner ear. Caffeine should also be avoided because it stimulates nerve endings.   

Drugs – taking daily diuretics can help to reduce fluid retention, and drugs to control balance can also help to alleviate symptoms of the disease.

Exercise – plenty of regular exercise is good for the circulation.

Operations – operations can be performed to either drain the endolymphatic sac or cut the vestibular nerve. These are usually performed when all other treatment has failed, but operating does not always cure the problem either.  

Injections – injecting gentamicin (antibiotic) into the middle ear can help to control vertigo, but there is a risk of hearing loss. Corticosteroids are therefore often used instead, as these are a much safer alternative.

Alternative medicine – alternative medicines are often used to alleviate some of the symptoms of Meniere’s disease, but there is no conclusive evidence to prove that they actually work. 

Is hearing loss inevitable with Meniere’s disease?

Hearing loss may be intermittent during the early stages of Meniere’s disease, but unfortunately this may become a permanent condition over time. It is generally the lower frequency sounds that are affected, but sometimes it can affect both high and low frequency sounds. Very loud noises may sound distorted and feel uncomfortable in the affected ear too.

Conclusion

As already stated, Meniere’s disease can be difficult to diagnose; so if you think that you may be suffering from the disease, it is a good idea to try and keep a diary of your condition. The diary should include details of all your symptoms, the frequency with which they occur and how long they last. This may help your doctor to make a more accurate diagnosis of the condition.   

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