Clinical Features, Diagnostic Investigations, and Management of Meniere's Disease

Introduction

Meniere's disease is an inner ear disorder characterized by recurrent episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness. The condition is believed to arise due to an imbalance in the endolymphatic fluid within the cochlea and vestibular system.

Diagnostic Investigations

Audiometric Testing

Audiometry is essential in diagnosing Meniere's disease. Patients exhibit low-frequency hearing loss in the affected ear, which may fluctuate over time.

Vestibular Assessment

Vestibular testing, including Electronystagmography (ENG) and Vestibular Evoked Myogenic Potentials (VEMP), evaluates inner ear function and detects abnormalities related to Meniere's disease.

Imaging

Magnetic Resonance Imaging (MRI) helps rule out vestibular schwannoma and other central nervous system abnormalities that may mimic Meniere’s symptoms.

Management

Medical Treatment

• Diuretics to reduce endolymphatic hydrops.
• Betahistine to enhance vestibular compensation.
• Corticosteroids for anti-inflammatory effects.

Dietary and Lifestyle Changes

• Low-sodium diet to decrease fluid retention.
• Avoid caffeine, alcohol, and tobacco.
• Stress management strategies to minimize exacerbations.

Surgical Options

Endolymphatic sac decompression and vestibular nerve sectioning may be considered in refractory cases.

Conclusion

Meniere’s disease requires a comprehensive diagnostic approach and tailored management strategies to mitigate symptoms and improve patients' quality of life.