Meniere’s disease or Meniere’s syndrome is a condition in which there is an excess of fluid in the inner ear. The excess fluid disturbs the ear’s balance and hearing mechanisms and produces a range of symptoms, including vertigo (a form of dizziness); tinnitus (a ringing noise in the ear); fluctuating hearing loss; and a feeling of pressure or fullness in the ear due to fluid build-up.
Vertigo attacks usually occur in clusters, with periods of remission ranging from days to years; and can occur without warning or predictability. As noted above, this vertigo is often accompanied by tinnitus, distorted hearing and pressure in the ear. In the early stages of the condition, hearing returns to normal levels following an attack; but as the disease progresses, measurable and permanent hearing loss occurs.
Meniere’s disease affects one in every 600 Australians. Most of those are diagnosed as having the disease in only one ear initially, but some people may go on to develop the disease in both ears.
Currently there is no known medical cure for Meniere’s. When Meniere’s symptoms cannot be managed by a combination of lifestyle measures and medication, medical devices or surgical intervention may be considered.
People with Meniere’s disease may experience increased distortion with their hearing aids, such that an optimally fitted hearing aid may not give them the speech understanding that would be expected from similar hearing levels in a non-Meniere’s patient. A dedicated speech test (which is different to a routine audiogram or hearing test) with and without the hearing aids will enable patients to understand the optimal solution for their hearing, such as if they should continue with hearing aids or should in fact consider a Cochlear Implant.
Some people develop ‘drop attacks’ or ‘Tumarkin crisis’ where they experience a sudden sensation of falling. Drop attacks are dangerous as they can happen anywhere and warrant surgical ablation of the balance or vestibular system. Surgical ablation may also be warranted if there is troublesome vertigo uncontrollable by other means and the hearing is also poor. Hearing can be given back at the same time as the ablative surgery by the means of a Cochlear implant, which tends to also be beneficial for tinnitus.