Meniere’s disease is a dysfunction of the fluids in the inner ear that is responsible for sound transmission and balance of the body as a whole. It normally occurs in individuals of the age group of 40-50 years but sometimes can appear in children too. The ear has prominently three chambers through which sound waves flow in and the endolymph inside the hollow labyrinth help in proper functioning of the ear. So, the disease is caused due to certain alterations in the endolymph properties. The alterations may be due to allergies or viral infection or due to an abnormal ear structure or improper fluid drainage. It can also occur due to genetic factors or fatigue, emotional stress, pressure changes, trauma on head, salty foods and abnormal immune response. The symptoms of the disease include vertigo wherein you have a feeling of spinning with attacks of seating, nausea and vomiting; tinnitus wherein you have the feeling of ringing or something swooshing in the ear and usually one ear is affected; hearing loss or deafness may be experienced with fullness in the ears sometimes and also, in some cases, photophobia occurs the patient suffers from increased sensitivity to light resulting in headaches and vertigo. Treatment for the disease cannot cure it completely but only reduces the symptoms to a much considerable level. Management of symptoms include medication for vertigo, surgery where medication fails to work, rehabilitation therapy and symptom management with the help of Meniett device.
As earlier stated, Meniere’s disease symptoms can only be reduced using a few methods but it cannot be cured completely. So, for teating the symptoms, doctors initially starts with medications with an antiemetic which is an anti-nausea medication which helps in checking the vomiting and the nauseating feeling caused due to vertigo. Your doctor can also prescribe you with an antidiuretic to help control the amount of fluid in the body and can also use middle ear injections like an antibiotic Gentamicin which is toxic to the inner ear resulting in reducing the balancing function of the ear thereby making the other ear responsible for controlling balancing function; another injection with steroids like dexamethasone is effective in controlling vertigo attacks which is performed with the help of local anaesthesia. In case of sever vertigo attacks doctors may go for surgery which include three types of procedures: Endolymphatic sac procedure wherein the either fluid production in the ear is decreased or its absorption is increased, in this method a small part of the ear is cut out from the sac and sometimes teamed with placing a shunt over it to drain excess fluid from the inner ear; in vestibular nerve section, the nerve connecting the movement sensors in the inner ear with balance sensors is cut; in labyrinthectomy, balance part of the ear is removed which in turn removes the hearing and balance functions from the affected ear.
Patients affected with vertigo or the spinning feeling, or patients with gradual hearing loss with nausea and vomiting, irregular heartbeat and dizziness, sweating or with a ringing and buzzing sound in one of the ear or a feeling of pressure in the ear or persons who have secondary symptoms like stress, anxiety and depression. While the said symptoms can be managed with medications and injections, in some cases where the symptoms are severe and cannot be managed by injections or medications, require surgery.
The gentamicin injection can have little side effect as it comes with the risk of causing further hearing loss in the affected ear. In certain cases where treatment with gentamicin injection fails, vestibular nerve section is suggested, but this procedure too come with a similar side effect of complete hearing loss in the affected ear. In some patients it cannot me determined which ear has been affected and is causing the symptoms. In that case, IM streptomycin is given daily twice to develop the signs of ototoxicity, thereby reducing vertigo attacks without impairing hearing. But the side effect of this treatment is that it damages the inner ear and results in symptomatic and disabling bilateral vestibular paresis.
A reduced sodium intake via diet is suggested as it helps in controlling water retention. It is important to be mobile and not be sedentary as this will help maintain balance. Also, daily liquid intake must be evenly distributed, a properly scheduled meal time must be followed, intake of salty foods must be restricted and the patient must also avoid other factors such as stress, allergens, caffeine and smoking. While it is necessary to keep moving for a better balance, it is also important you take proper rest after the treatment. You must avoid driving car and oerating heavy machinery.
As already mentioned, Meniere’s disease cannot be cured completely and only be treated to reduce and manage symptoms so that the patients can learn to live with it. To recover from an attack, it takes 2-4 hours but coping with disease has to be continued all throughout your life.
The cost of treatment includes doctors’ consultation fees, medications or rehabilitation procedures or surgery in some cases. So, encircling all costs, it starts from Rs. 200 and can go up to Rs. 22,700.
The results cannot be said permanent because the traetments do not cure the disease completely. But, yes, the coping and management procedures are quite effective and if done rightly, it can be kept in control.
Some herbs like gingko biloba, turmeric, cayenne and ginger root have been proved to relieve symptoms of vertigo. There are a few solutions with homoeopathic medicines also like salicylicum acidum and nux vomica which have been found to be effective along with a plant, Cocculus indicus as a conventional treatment. Some foods that must be avoided to manage Meniere’s disease are alcohol, caffeine rich foods, chocolates, smoking nicotine, monosodium glutamate (MSG) found in several packaged foods and too salty foods. You must also intake at least 6-8 glasses of water daily to maintain fluid balance in the body.
Rs. 200 to Rs. 23,000