02 Aug Meniere's disease therapy: How the ear disease can be treated

Rotational vertigo, which occurs in attacks and is accompanied by ringing in the ears and hearing loss, is a sign of Meniere's disease. This is a disease of the inner ear. It is presumably caused by excess pressure that manifests itself there. The disease cannot be cured, but with the right treatment for Meniere's disease, we can reduce the severity and frequency of the attacks.

Changes in the inner ear due to Menière's disease

Prosper Menière, a French physician, described inner ear disease as early as 1861. It was therefore named after him. According to current knowledge, there is still no clear cause for Meniere's disease. Scientists associate various factors with the occurrence of inner ear disease. These include frequent viral infections (e.g. herpes virus), immunological diseases, injuries, hormonal disorders, circulatory disorders and a family predisposition.

The most popular theory is that of changes in the inner ear. It houses the cochlea and the organ of balance, as well as two different fluids: the perilymph and the endolymph. They are in a sensitive balance and characterise the function of the organ. In Meniere's disease, the resorption of the potassium-rich endolymph in the inner ear appears to be disturbed.

Menière's triad: three characteristic symptoms of Menière's disease

Rotational vertigo

Typical for Menière's disease is a strong Rotational vertigowhich occurs in attacks. Patients have the feeling that their surroundings are spinning around them very quickly - comparable to a ride on a merry-go-round. The vertigo attacks are sometimes even so severe that those affected have to lie down. Rotational vertigo often causes nausea, vomiting and even falls. Patients find this symptom particularly distressing as the dizziness occurs suddenly and without warning. It can last for hours or even days.

Tinnitus

In addition to the attacks of vertigo, around 90 % of Meniere's disease patients suffer from ringing in the ears. They hear a buzzing, whistling, hissing or ringing that has no localisable source - i.e. does not exist objectively. In Menière's disease, the Tinnitus often low-frequency. This means that the ringing in the ears tends to be perceived as low-pitched. In addition, there is often a humming, rushing noise.

Hearing loss / hearing impairment

The third typical symptom of Meniere's disease is hearing loss, which usually only affects one ear. Patients hear significantly worse, especially in the lower frequency range. Usually only one ear is affected, but as the disease progresses, the hearing loss can also spread to the second ear. Complete deafness is even possible.

In addition to this characteristic triad, other symptoms can also occur. For example, those affected often become pale and sweaty. Their eyes may start to tremble (nystagmus).

How we can treat the disease

Meniere's disease is very stressful for patients, as the attacks occur suddenly. Especially for older patients, who already have an increased tendency to fall, torsional vertigo is particularly dangerous. The aim of Meniere's disease therapy is to reduce the symptoms during an acute attack and to prevent new attacks. There are various options for this:

Acute therapy

We achieve good results with anti-dizziness medication (antivertiginosa). There are various active ingredients (e.g. dimenhydrinate or, in particularly severe cases, diazepam). Patients take them to combat the acute attack of dizziness and against the nausea/vomiting. We recommend that patients carry the tablets with them at all times so that they can react immediately in the event of a sudden attack.

Prophylaxis: Prevention of new seizures

In addition to acute treatment, Ménière's disease therapy also aims to reduce the number of attacks that occur. Here, too, we can use various medical agents, such as betahistine. With the right dose, customised to the patient, the occurrence of symptoms can be significantly reduced. The medication does not have to be taken at a high dose on a permanent basis: After six months to a year, we can try to slowly reduce the dose.

Intratympanic corticosteroid therapy with the anti-inflammatory cortisone is also suitable as a preventive measure. Under local anaesthetic, we inject the medication through the eardrum into the middle ear. This allows it to reach the inner ear, where it can exert its anti-inflammatory and vasoconstrictor effects.

Psychological support

Supportive psychological care can also be useful for patients, as the unpredictable attacks sometimes place a heavy psychological burden on patients.

Treatment of the vestibular system

Another, albeit radical, option for treating Meniere's disease is to "switch off" the vestibular organ. This is possible by administering medication. This involves injecting a specific antibiotic into the middle ear, which renders the organ of balance in the inner ear non-functional. Surgical intervention is also an option. However, this form of treatment can have serious side effects, such as hearing loss, deafness or a complete loss of the sense of balance.

Alternative forms of treatment

There are also homeopathic treatment approaches to treat Meniere's disease. It is recommended to take Cocculus D6 three times a day. Tabacum D12 can probably interrupt an acute attack. Another supportive therapy is acupuncture or targeted balance training.

Meniere's disease therapy in Frankfurt

If you suffer from the symptoms described, a visit to our ENT clinic in Frankfurt is absolutely necessary. Special examination methods and the Hearing and dizziness diagnostics we will find out whether you suffer from Menière's disease and can recommend a suitable therapy for you.

ENT Frankfurt: Dr Thomas Fischer & Dr Albrecht Linke

Your specialists for ear, nose and throat medicine, who will provide you with professional and individualised advice, examinations and treatment in all matters relating to ENT medicine, functional plastic surgery and the aesthetic treatment of changes to the facial skin.

Our news articles are prepared for you to the best of our knowledge and belief and are intended for general education. They are in no way a substitute for medical advice, diagnosis and treatment and are not intended to encourage self-diagnosis or self-treatment. Please always contact your ENT specialist in Frankfurt directly if you have any health complaints!

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