Meniere’s Disease
• Understanding the Causes, Symptoms, and
Management
• Presented by: DR V. THIRUMALAI PRIYA
Introduction
• • Meniere’s disease is a chronic inner ear
disorder causing episodic vertigo , fluctuating
hearing loss and tinnitusnand often a
sensation of fluctuating ear fullness
• • Affects balance and hearing.
• • Usually affects one ear.
• • Named after Prosper Ménière (1861).
Anatomy of the Inner Ear
Pathogenesis of menieres
• The pathogenesis of Meniere’s disease involves a
multifactorial process primarily centered on endolymphatic
hydrops, which is an abnormal accumulation of endolymph
(fluid) in the inner ear's membranous labyrinth.
• 1. Endolymphatic Hydrops (Core Mechanism)Endolymph is
the fluid within the inner ear that helps with hearing and
balance.In Meniere’s disease, endolymphatic fluid builds
up, distending the membranous labyrinth.This distension
disrupts the normal structure and function of the inner ear.-
• -.
• -2. Disruption of Ionic BalanceThe inner ear requires
precise ionic gradients (especially potassium and
sodium) for normal sensory cell function.Fluid
accumulation disturbs these gradients, impairing hair
cell function in the cochlea (hearing) and vestibular
organs (balance).
• 3. Rupture of MembranesIn some cases, the
membrane separating endolymph and perilymph
ruptures.This causes mixing of the fluids, which have
different ionic compositions—leading to sudden vertigo
and hearing symptoms.
4. Inflammatory and Immune FactorsSome evidence suggests
autoimmune or inflammatory processes may
contribute.Immune-mediated damage to the endolymphatic
sac might impair fluid absorption, worsening hydrops.
5. Vascular and Anatomic FactorsNarrowed venous drainage or
congenital abnormalities might impair inner ear fluid
homeostasis.Hormonal and stress-related changes might also
affect fluid regulation.
6. Chronic DegenerationRepeated episodes can lead to
permanent damage to the sensory cells of the cochlea and
vestibular organs.
Causes and Risk Factors
• • Excess fluid (endolymph) in the inner ear.
• • Possible causes:
• - Autoimmune responses
• - Allergies
• - Viral infections
• - Genetic predisposition
• • Risk factors: family history, migraines,
middle ear infections.
Symptoms
• • Vertigo (spinning sensation)
• • Hearing loss (fluctuating and progressive)
• • Tinnitus (ringing in the ear)
• • Aural fullness (feeling of pressure in the ear)
Diagnosis
• • Audiometry (hearing test)
• • Electronystagmography (ENG) or
videonystagmography (VNG)
• • Electrocochleography (ECoG)
• • MRI to rule out other conditions
Treatment Options
• • Lifestyle Changes: low-salt diet,
caffeine/alcohol reduction
• • Therapies: vestibular rehab, hearing aids
• • Surgical Options: endolymphatic sac
decompression,
cochleosacculotomy,vestibular neurectomy,
labyrinthectomy
• • Medications:
• vestibular sedatives
• vasodilators -carbogen , histamine
diphosphate
• pulse positive pressure
• Diuretics
• anti-nausea
• corticosteroids
• Surgical Options:
• endolymphatic sac decompression
cochleosacculotomy
• vestibular neurectomy
• labyrinthectomy
Living with Meniere’s Disease
• • Managing triggers
• • Support groups and counseling
• • Impact on quality of life
Prognosis
• • Chronic condition with variable progression
• • Hearing loss may become permanent
• • Symptom control possible with treatment
Conclusion
• • Early diagnosis helps manage symptoms.
• • Multidisciplinary care is important.
• • Ongoing research into causes and new
treatments.
