Ménière Disease

Ménière disease is a disorder of the inner ear that affects your balance and hearing. The most common symptoms are sudden episodes of extreme dizziness or a spinning sensation known as vertigo, ringing in the ears (tinnitus), a feeling of pressure or fullness in the ears, and hearing problems. These symptoms can make it difficult to carry out everyday activities.

This disorder is caused by a buildup of fluid in the part of the inner ear called the labyrinth. When this happens, it can interfere with the normal balance and hearing signals between the inner ear and the brain.

Episodes of Ménière disease come and go and can’t be predicted. You may have several episodes in a short period, followed by months or years with no symptoms. When they occur, episodes generally last several hours, and can be triggered by a variety of factors including allergies, stress, fatigue, infection or an abnormal immune system response.

Ménière disease appears most often in middle age, when someone is in their 40s or 50s. The symptoms typically begin in one ear but may progress to involve both ears. It appears to affect men and women equally.

In the early stages of Ménière disease, many people have no symptoms between episodes. But over time, chronic problems with balance, tinnitus and a feeling of fullness in the ears can develop. Also, permanent hearing loss can eventually occur.

There is no cure for Ménière disease, but there are treatments to help manage the symptoms. Because this disorder can mimic other potentially life-threatening conditions, it’s important to see a healthcare provider for an accurate diagnosis as soon as symptoms appear.

Why Choose Cooper to Diagnose and Treat Ménière Disease

As the region’s only academic health system, Cooper is home to experts in more than 75 specialties, giving you access to all the expertise you need, all in one place. When it comes to Ménière disease, we offer:

  • A team of specialists in neurology, otolaryngology (ear, nose and throat/ENT) as well as audiology, who work together to ensure that you get a timely, accurate diagnosis and appropriate treatment
  • State-of-the-art diagnostic technology
  • A full range of conservative (nonsurgical) and surgical treatment options

Causes and Risk Factors for Ménière Disease

The specific cause of Ménière disease is still unknown, although it probably results from a combination of environmental and genetic factors, including:

  • Allergies
  • An abnormal immune system response
  • A blockage that interferes with fluid drainage
  • Head injury/trauma to the inner ear
  • Infection
  • Migraines
  • Stress
  • Fatigue
  • Genetic predisposition

Risk factors for Ménière disease include:

  • Age: While anyone can get this disorder, it’s more common in people in their 40s and 50s, and rare in children
  • Family history: In a small percentage of cases it appears to run in families

Symptoms of Ménière Disease

The most common symptoms of Ménière disease are:

  • Vertigo: A severe spinning sensation that can cause nausea and vomiting
  • Tinnitus: The perception of a ringing, roaring, hissing or buzzing sound in the ear
  • Hearing loss: Inability of hear low frequencies, a sense of muffled hearing
  • A sense of fullness in the ear: A feeling of pressure (called aural fullness) in the affected ear(s)
  • Loss of balance: This can increase the risk of falling and serious injury
  • Headaches

Symptoms are unpredictable; they can come on suddenly and may occur daily, once or twice a year, or even less frequently. Symptoms most often occur in one ear but can affect both ears.

Treating Ménière Disease

After a comprehensive evaluation to assess your hearing and balance and rule out other causes of your symptoms, treatment will be tailored to your individual situation and may include:

  • Medications: These may include motion sickness or anti-nausea drugs to manage vertigo symptoms, medicines to control allergies, or diuretics to reduce fluid retention
  • Rehabilitation: Vestibular rehabilitation therapy may help if you have balance issues between episodes of vertigo
  • Hearing aid(s): When hearing is affected, an audiologist can recommend an appropriate hearing aid in the affected ear(s)
  • Positive pressure therapy: For hard-to-treat vertigo, this therapy may lessen fluid buildup in the ear by applying pulses of pressure to the ear canal through a ventilation tube. You perform the treatment at home, usually 3 times a day for 5 minutes at a time.
  • Dietary changes: Eliminating alcohol, salt, caffeine and chocolate may reduce the severity and frequency of symptoms  
  • Behavioral therapies: Stress management may lessen the severity of symptoms
  • Surgery: When conservative measures do not relieve vertigo symptoms, there are several surgical options that may be considered:
    • Endolymphatic sac decompression: In this procedure, the sac containing endolymph (inner ear fluid) is decompressed in order to reduce excess fluid levels. A shunt may also be placed to drain excess fluid from the inner year.
    • Labyrinthectomy: The surgeon removes the balance part of the inner ear, eliminating both the balance and hearing function from the affected ear. This procedure is only performed if you already have severe or total hearing loss in the affected ear.
    • Vestibular nerve section: Cutting the vestibular nerve—the nerve that connects balance and movement sensors in the inner ear to the brain—may correct vertigo problems while preserving hearing in the affected ear. This procedure requires general anesthesia and an overnight hospital stay.

Make an Appointment With a Ménière Disease Expert at Cooper

To learn more about the resources available for diagnosing and treating Ménière disease at Cooper or to request an appointment, please call 800.8.COOPER (800.826.6737).