Hearing Loss and Ménière's Disease

Ménière's disease is characterized by an abnormality of the inner ear resulting in many symptoms that affect a person's inability function normally in everyday life.

Changes in fluid volume in the labyrinth are a prime factor. The labyrinth (inner ear) consists of the bony labyrinth containing perilymph, which surrounds the membranous labyrinth. The membraneous labyrinth contains a fluid called endolymph that moves with head motion, and causes nerve receptors to send signals to the brain. Endolymphatic hydrops occurs when there is an increase in endolymph, resulting in the dilation of the labyrinth. Rupture of the membranous labyrinth allowing mixture of endolymph and perilymph to occur, may also include environmental and biological factors.

Symptoms:

• Hearing loss of several hours or more


• Vertigo,


• severe nausea,


• vomiting


• sweating


• Tinnitus


• Feelings of fullness or pressure in the ear


• Headache


• Abdominal pain


• Diarrhea

Diagnosis:

In the US there are about 615,000 people are diagnosed Ménière's disease, and approximately 45,500 new cases annually. Diagnosis of this condition includes:

1. Medical history


2. Hearing and balance tests


3. MRI

Hearing loss is determined to be either sensory from the inner ear, or neural relating to the hearing nerve (the cochlear nerve). Brain stem response is the electrical activity that occurs in the cochlear nerve and the brain stem. Electrocochleography, records electrical activity of the inner ear in response to sound

The vestibular (balance) is tested by irrigation the ear canals (caloric testing) with warm and cool water or air and results in rapid eye movements. Tumors can mimic symptoms of Ménière's disease, An MRI can differential between Ménière's disease and a tumor.

Treatment:

Ménière's disease has no cure, but symptoms of the condition can be managed by reducing fluid retention and through dietary changes, such as a low-salt or salt-free diets, including and no caffeine or alcohol, as well as medication. Stopping smoking and decreasing stress levels help to reduce symptoms.

Surgical procedures such as removal of the inner ear sense organ (labyrinthectomy) is effective in the management vertigo symptoms. Hearing may be lost and is why this procedure is mainly used on people with profound hearing deafness in the effected ear. Vestibular neurectomy involves the severing of a nerve from the affected inner ear organ. This procedure controls the vertigo while preserving hearing.

Research On Ménière's:

Currently, the investigation into environmental and biological factors is being conducted, as well as the study of the movement of endolymph and perilymph fluids in the labyrinth affect hearing and balance. The study of the hair cells in the cochlea, which are responsible for proper hearing and balance, includes looking into how the ear converts sound waves into nerve impulses. This will aid in the development of prevention tactics, in addition to more effective treatment.

by Barb Hicks, RN/LMT