Meniere's Disease
Definition
Episodic attacks of tinnitus, hearing loss, aural fullness, and vertigo lasting minutes to hours
Aetiology
Inadequate absorption of endolymph leads to endolymphatic hydrops (over accumulation) that
distorts the membranous labyrinth
Epidemiology
Clinical Features
Treatment
Acute management may consist of bed rest, antiemetics (Stemetil), diazepam, antivertiginous drugs (betahistine = Serc)
Long term management may include:
Medical
Surgical:
Toronto Notes 2012
Dr Gavin Earles 2014
Episodic attacks of tinnitus, hearing loss, aural fullness, and vertigo lasting minutes to hours
Aetiology
Inadequate absorption of endolymph leads to endolymphatic hydrops (over accumulation) that
distorts the membranous labyrinth
Epidemiology
- Peak incidence 40 to 60 yrs
- Bilateral in 35% of cases
Clinical Features
- Quadrad: Vertigo, fluctuating low frequency sensorineural hearing loss (SNHL), tinnitus, and aural fullness
- ±drop attacks (Tumarkin crisis = sudden falls occuring without warning/ LOC),± nausea and vomiting
- Vertigo disappears with time (minutes to hours), but hearing loss remains
- Early in the disease: fluctuating sensorineural hearing loss (SNHL)
- Later stages: persistent tinnitus and low-frequency hearing loss
- Attacks come in clusters and can be debilitating to the patient
Treatment
Acute management may consist of bed rest, antiemetics (Stemetil), diazepam, antivertiginous drugs (betahistine = Serc)
Long term management may include:
Medical
- Prophylaxis: low salt diet, Serc, diuretics
- Local application of gentamicin to destroy vestibular end-organ, results in complete SNHL
Surgical:
- Endolymphatic sac decompression
Toronto Notes 2012
Dr Gavin Earles 2014