Meniere’s disease is a pus-like disease of the inner ear, characterized by an increase in the volume of the labyrinth fluid and an increase in intralabirint pressure, resulting in bouts of progressive deafness, tinnitus, dizziness and imbalance, as well as autonomic disorders (nausea, vomiting)
Usually, Meniere’s disease is a unilateral process, in 10-15% of cases it is bilateral.
The disease develops without a preceding purulent process in the middle ear and organic diseases of the brain and its membranes. The severity and frequency of attacks may decrease with time, but the hearing loss progresses.
The prevailing age for the development of Meniere’s disease is 30-50 years.
- The classic form of Meniere’s disease – a simultaneous violation of the auditory and vestibular functions (approximately 30% of cases)
- Cochlear form – the disease begins with hearing impairment (50% of cases)
- Vestibular form – the disease begins with vestibular disorders (15-20% of cases).
There are several theories linking the occurrence of this disease with the reaction of the inner ear (in the form of increasing the amount of labyrinth fluid and increasing pressure inside the maze) to various injuries.
- Violations of water-salt metabolism
- Allergic diseases
- Endocrine diseases
- Vascular diseases
- Viral diseases
- Dysfunction of endolymphatic duct and endolymphatic sac
- Deformation valve Basta
- Blockage of the pipeline
- Decreased airiness of the temporal bone.
In recent years, the theory that explains the occurrence of this disease by impaired function of the nerves innervating the vessels of the inner ear is in the center of attention.
- Paroxysmal flow (during the interictal period, signs of the disease are usually absent, with the exception of hearing loss).
- Gradual hearing loss, predominantly low-frequency in the early stages of the disease; periodic deterioration and sudden improvement in hearing
- Vertigo – spontaneous attacks lasting from 20 minutes to several hours
- Noise in ears
For severe attacks of Meniere’s disease, the following manifestations are characteristic: nausea and vomiting, pallor, severe sweating, decrease in body temperature, loss of the ability to maintain balance, the severity of manifestations increases with movement.
The diagnosis is made by the ENT doctor. Laboratory studies are aimed at the exclusion of other diseases with similar manifestations.
- Specific serological tests to detect pale treponema
- Examination of thyroid function
- Research on fat metabolism.
- Hearing study
- Study of the vestibular apparatus
- Visualization – magnetic resonance imaging to exclude the auditory nerve neuroma.
Outpatient treatment is usually indicated for Meniere’s disease. The attack can be stopped on an outpatient basis. If necessary, surgery of the patient is hospitalized.
Physical activity is limited during seizures. Recommended full physical activity in the interictal period
Diet in the treatment of Meniere’s disease: limiting food intake during bouts of nausea. In some cases it is advisable to limit the consumption of salt. Diet does not belong to the factors that provoke the occurrence of seizures.
Patients with Meniere’s disease should not work in extreme conditions (on underground, underwater or high-altitude works), in the zone of increased risk of injury (for moving machinery), while servicing any types of vehicles
The peculiarity of patients with Meniere’s disease is pronounced emotional lability, so they need increased attention.
It is extremely important to conduct a periodic assessment of hearing due to its progressive deterioration.
Drugs of choice during an attack (one of the drugs):
In the interictal period:
- meklozin 25-100 mg orally before bedtime or in several doses,
- phenobarbital or diazepam,
- hydrochlorothiazide together with potassium preparations,
In most cases, conservative treatment of Meniere’s disease is effective, but in 5-10% of cases surgical treatment is necessary in connection with dizziness.