Meniere's Disease

Meniere's disease is a disorder that causes hearing symptoms as well as problems with balance. Thought to be caused by fluid overload in the inner ear, Meniere’s disease is a chronic condition. However, the right treatment can help control the symptoms of Meniere’s disease and restore your quality of life.

The University of Kansas Health System is home to comprehensive ear, nose and throat care as well as a dedicated Hearing and Balance Center. Together, our specialists offer coordinated care to help you effectively manage your Meniere’s disease symptoms.

Meniere's disease is a relatively rare disorder of the inner ear that typically only affects one side. Considered a lifelong condition, Meniere’s disease can cause repeated dizzy spells that last for several minutes up to several hours. This disorder can also lead to hearing loss.

Although the symptoms of Meniere’s disease are caused by excessive fluid buildup in the inner ear, doctors aren’t sure what causes that to happen in the first place. Typically, Meniere’s disease starts during the years between young adulthood and middle age, although the condition can occur at any age.

Symptoms of Meniere’s disease typically include fullness, pressure and ringing in the ears with accompanying vertigo. However, not all people will begin with these symptoms and some may never have all of the symptoms. The number of people who develop bilateral Meniere’s disease (symptoms on both sides) varies and has been reported to vary from 20-60%.

Typically, the symptoms of Meniere’s disease will worsen during the course of an attack and may resolve completely after the attack. The vertigo present during an attack frequently lasts several hours with an entire episode lasting approximately 24 hours.

There are several risk factors that may contribute to the development of Meniere’s disease:

• An abnormal immune system response
• Genetic factors
• Poor inner ear fluid drainage
• Viral infections

Properly diagnosing Meniere's disease begins with a physical exam and full medical history. Meniere's disease symptoms must meet specific conditions:

• You've experienced 2 episodes of vertigo that lasted 20 minutes or more (but less than 12 hours)
• You have measurable hearing loss
• You experience ringing in your ear (tinnitus) or a persistent feeling of fullness in your ear

As part of this assessment, your doctor will include a hearing test and a balance assessment. Your doctor may also schedule additional blood tests or imaging scans to rule out underlying health conditions or different disorders that could cause symptoms that are similar to Meniere's disease.

People who are living with Meniere’s disease can sometimes find relief from their symptoms with dietary changes and medical therapy. Many find this is a disorder they can manage with minimal disruption to their lives. However, everyone is different, and some will need further procedures to control their symptoms.

Control of dietary salt to a level of 1500-2000 milligrams per day has been shown to effectively control most people’s Meniere’s disease symptoms. The reason is because of salt’s effect on water balance in the inner ear. In people with significant symptoms, a mild diuretic can also be prescribed to further help reduce water in the body, specifically in the ear.

As a very mild diuretic, a banana or other food high in potassium can be taken 2-3 times per week. Intake of caffeine and alcohol should be limited as well, at least initially. If good control of symptoms is achieved, then periodic hearing tests (used to follow the course of the disease) will show preservation of hearing in the affected ear.

In some cases, where control of dietary factors is not successful and symptoms are more severe, surgery may be an option. There are several surgical options to treat Meniere’s disease:

• Endolymphatic sac procedures have about a 70-80% chance of control of vertigo and stabilization of hearing in the right candidates. Decompression and/or shunting and vestibular nerve section are relied on heavily in the management of Meniere’s disease symptoms.
• A labyrinthectomy can be performed in people with limited hearing in the affected ear.

Surgical treatment of Meniere’s disease can have varying effects on hearing and other factors related to the disorder. Your doctor will discuss each treatment option with you in more detail before your procedure.