What is Ménière’s syndrome?
Ménière’s syndrome, named after the French physician who discovered it in 1861, is a disease that affects the ear, usually only one ear at a time, and manifests with symptoms such as whistling (tinnitus), ringing, throbbing, deafness (“plugged ears”) and progressively nausea and vomiting, dizziness and hearing loss (hypoacusis). Episodes may recur at longer or shorter intervals. Attacks of vertigo, in particular, may become severe enough to cause loss of balance and falls.
What are the causes of Meniere’s syndrome?
Although a specific origin of the disease has not yet been established, according to some research, Ménière’s syndrome is caused by vasoconstriction, the origin of which is often found in previous viral infections, autoimmune reactions, allergies or in some cases heredity. The symptoms of Ménière’s disease are due to an abnormal accumulation of fluid in the inner ear canal, the labyrinth. The function of maintaining balance is carried out by the semicircular canals and the otoliths, small organs located inside the labyrinth. The labyrinth is further divided into two parts: the bony labyrinth and the membranous labyrinth. The latter contains the organs of equilibrium and is where the endolymphatic fluid imbalance occurs. In a normal situation, the balance organs stimulate the receptors immersed in this fluid and in turn send information to the brain about movement and position, whereas in the presence of Ménière’s disease the accumulation is such that it prevents the normal work of the receptors and produces the aforementioned symptoms. Although it can develop at any age, the most affected group remains those aged 40 to 60 years. In addition, people with immune disorders, autoimmune diseases, viral infections, chemical imbalances of electrolytes in the ear, circulation-related diseases or cases in the family are at increased risk.
Ménière’s syndrome is caused by vasoconstriction often originating from previous viral infections.
Diagnosis of Ménière’s syndrome
The first step in the diagnosis of Ménière’s syndrome begins with the patient’s clinical history and an examination by the otolaryngologist. The diagnosis is based primarily on the presence of the symptoms described above that have a duration of more than 20 minutes per episode. In some cases, during the examination, the physician will also attempt to assess hearing loss, as this is considered the most important symptom of the disease. The examination can be used to determine whether the hearing loss originated in the inner ear, i.e. sensory hearing, or in the acoustic nerve, i.e. neutral hearing. This is done with electrocochleography, which records the electrical response of the ear to sound. In addition, to check the state of the vestibular system, which is responsible for balance, the specialist can also resort to nystagmus or the procedure by which water or air is introduced into the ear until it causes involuntary eye movements, from which the problem with balance can be detected. To exclude the diagnosis of cancer, the acute phase of which presents symptoms similar to those of Ménière’s disease, it is also advisable to perform CT and MRI tests.
Treatments for Ménière’s syndrome
To date, there is no specific treatment for Ménière’s disease, but a mixture of different treatments is used to improve symptoms. Pharmacological treatment based on psychotropic drugs and first-generation antihistamines acting on the symptoms of dizziness is the first method used. In more complex cases, antiemetic drugs to combat vomiting, anti-inflammatory drugs and immunosuppressants may also be used. It has also been shown that some dietary changes can be beneficial in the fight against this disease. These include: reduction of salt, to reduce water retention and thus fluid accumulation in the ear; elimination of tobacco, alcohol, chocolate and caffeine, which worsen the overall symptoms. Psychological treatment to help the person cope better with episodes of vertigo attacks and thus improve their quality of life is another tool. Finally, in cases where none of the above treatments have produced improvements, surgery may be used to decompress the endolymphatic sac, the end part of the membranous labyrinth, or cut the vestibular nerve.