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THE ISLANDER, NOVEMBER 29, 2010, PAGE 5
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The Audiology Corner
By Kendall Varney,
Clinical Audiologist
Coastal Hearing and Balance
Menier's Disease
What is Meniere's disease?
Meniere's disease is an abnormal
ity of the inner ear causing a host of
symptoms, including vertigo or severe
dizziness, tinnitus or a roaring sound
in the ears; fluctuating hearing loss,
and the sensation of pressure or pain
in the affected ear.
The disorder usually affects only one
ear and is a common cause of hearing
loss. It is named after French physician
Prosper Meniere, who first described
the syndrome in 1861.
What causes Meniere's disease?
The symptoms of Meniere's disease
are associated with a change in fluid
volume within a portion of the inner
ear known as the labyrinth. The laby
rinth has two parts: the bony laby
rinth and the membranous labyrinth.
The membranous labyrinth, which is
encased by bone, is necessary for hear
ing and balance and is filled with a
fluid called endolymph. When your
head moves, endolymph moves, caus
ing nerve receptors in the membranous
labyrinth to send signals to the brain
about the body's motion. An increase
in endolymph, however, can cause the
membranous labyrinth to balloon or
dilate, a condition known as endolym
phatic hydrops.
Many experts on Meniere's disease
think that a rupture of the membra
nous labyrinth allows the endolymph to
mix with perilymph, another inner ear
fluid that occupies the space between
the membranous labyrinth and the
bony inner ear. This mixing, scientists
believe, can cause the symptoms of
Meniere's disease.
Scientists are investigating several
possible causes of the disease, includ
ing environmental factors, such as
noise pollution and viral infections, as
well as biological factors.
What are the symptoms of Meniere's
disease?
The symptoms of Meniere's disease
occur suddenly and can arise daily or
as infrequently as once a year. Vertigo,
often the most debilitating symptom of
Meniere's disease, typically involves a
whirling dizziness sensation that forces
the sufferer to lie down. Vertigo attacks
can lead to severe nausea, vomiting,
and sweating and often come with little
or no warning.
Some individuals with Meniere's
disease have attacks that start with
tinnitus (ear noises), a loss of hear
ing, or a full feeling or pressure in the
affected ear. It is important to remem
ber that all of these symptoms are
unpredictable. Typically, the attack is
characterized by a combination of ver
tigo, tinnitus, and hearing loss lasting
several horn’s.
People experience these discomforts
at varying frequencies, durations, and
intensities. Some may feel slight ver
tigo a few times a year. Others may
be disturbed occasionally by intense,
uncontrollable tinnitus while sleeping.
Meniere's disease sufferers also may
notice a hearing loss and feel unsteady
all day long for prolonged periods.
Other occasional symptoms of
Meniere's disease include headaches,
abdominal discomfort, and diarrhea.
A person's hearing tends to recover
between attacks but becomes worse
over time.
How is Meniere's disease diag
nosed?
Based on a recent study, NIDCD
(National Institute on Deafness and
Other Communication Disorders) esti
mates that there are approximately
615,000 individuals with diagnosed
Meniere's disease in the United States
and 45,500 newly diagnosed cases each
year.
Proper diagnosis of Meniere's dis
ease entails several procedures, includ
ing a medical history interview and a
physical examination by a physician,
hearing and balance tests, and medi
cal imaging with magnetic resonance
imaging (MRI). Accurate measurement
and characterization of hearing loss
are of critical importance in the diag
nosis of Menisre's disease.
Through the use of several types of
hearing tests, physicians can character
ize hearing loss as being sensory (aris
ing from the inner ear) or neural (aris
ing from the hearing nerve). Record
ing the auditory brain stem response,
which measures electrical activity in
the hearing nerve and brain stem, is
useful in differentiating between these
two types of heating loss. Electroco-
chleography, which records the electri
cal activity of the inner ear in response
to sound, helps confirm the diagnosis.
To test the vestibular or balance sys
tem, physicians irrigate the ears with
warm and cool water or air. This proce
dure, known as caloric testing, results
in nystagmus, or rapid eye movements,
that can help a physician analyze a bal
ance disorder. Since tumor growth can
produce symptoms similar to Meniere's
disease, an MRI is a useful test to
determine whether a tumor is causing
the patient's vertigo and hearing loss.
How is Meniere's disease treated?
There is no cure for Meniere's dis
ease. However, the symptoms of the
disease are often controlled success
fully by reducing the body's retention of
fluids through dietary changes (such as
a low-salt or salt-free diet and no caf
feine or alcohol) or medication. Chang
es in medications that either control
SGHS Foundation donates funds for ren
ovations, mannequin purchase
From left are: Bishop, Health System President & CEO Gary R. Colberg,
FACHE, and Glynn Brunswick Hospital Authority Vice Chair Carl Alexan
der.
The Southeast Georgia Health
System Foundation has donated $1.3
million to the Health System which
will used to complete renovations
allergies or improve blood circulation
in the inner ear may help. Eliminating
tobacco use and reducing stress levels
are more ways some people can lessen
the severity of their symptoms.
Different surgical procedures have
been advocated for patients with
persistent, debilitating vertigo from
Meniere's disease. Labyrinthectomy
(removal of the inner ear sense organ)
can effectively control vertigo, but
sacrifices hearing and is reserved for
patients with nonfunctional hearing
in the affected ear. Vestibular neurec
tomy (selectively severing a nerve from
the affected inner ear organ) usually
controls the vertigo while preserving
hearing, but carries surgical risks.
Recently, the administration of the
ototoxic antibiotic gentamycin directly
into the middle ear space has gained
popularity worldwide for the control of
the vertigo of Meniere's disease.
What research is being done?
Scientists are investigating environ
mental and biological factors that may
cause Meniere's disease or induce an
attack. They also are studying how
fluid composition and movement in the
labyrinth affect hearing and balance.
By studying hair cells in the inner ear,
which are responsible for proper hear
ing and balance, scientists are learning
how the ear converts the mechanical
energy of sound waves and motion
into nerve impulses. Insights into the
mechanisms of Meniere's disease will
enable scientists to develop preventive
strategies and more effective treat
ment. □
of patient rooms at the Brunswick
Campus, as well as purchase the
technologically-advanced medical
mannequin, Sim Woman. “Today it
is more important than ever for each
of us to support Southeast Georgia
Health System through our finan
cial contributions. Gary Colberg and
his outstanding team of profession
als work tirelessly to provide the
residents of Southeast Georgia with
state-of-the-art medical facilities
that are staffed with qualified and
caring employees who utilize the
latest innovations in medical equip
ment and technology,” said James
Bishop Chairman of the Foundation
Board of Directors. □
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