Meniere's Disease

Ménière's disease is a disease of the inner ear arising from dysfunction of the endolymphatic sac. Women and men are affected equally. The disease mainly occurs in patients aged 30–60 years.

Pathogenesis

Saccus endolymphaticus ensures the resorption of endolymph. Its dysfunction results in the accumulation of endolymph and expansion of the labyrinth, which leads to its rupture. Endolymph is rich in potassium and therefore diffuses into the potassium-poor perilymphatic fluid. This leads to depolarization of the vestibulocochlearis neuron.

Clinical symptoms

• The main symptoms of Ménière's disease include: Paroxysmal vertigo (we are talking about so-called attacks of rotational vertigo, often preceded by an aura), Tinnitus (humming or whistling in the ears; in Ménière's disease the tinnitus is unilateral), Hypacusia (this is a perceptual cochlear hearing disorder; in Ménière's disease, hypacusia is unilateral).

Diagnosis

Ménière's disease can be diagnosed based on: anamnesis (2 or more past seizures); audiometry (we demonstrate a shift in hearing threshold by more than 10 dB); exclusion of other pathological conditions that could lead to a similar clinical manifestation (CT, MRI, lumbar puncture, angiography can be used...).

Treatment

The causal treatment for Ménière's disease is unknown. They are used: special dietary measures – limit salt, limit intake of caffeine, alcohol; diuretics; betahistine.

In case of failure of conservative therapy, surgical intervention can be performed.

Links

• BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2009]. <http://jirben2.chytrak.cz/materialy/orl_jb.doc>.
• KLOZAR, Jan, et al. Speciální otorinolaryngologie. 1. vydání. Praha : Galén, 2005. 224 s. ISBN 80-7262-346-X.
• MLČOCH, Zbyněk. Menierova nemoc, Menierův syndrom – příznaky, projevy, léčba, diagnostika, vyšetření [online]. ©c2003-2010. [cit. 2017-10-12]. <http://www.zbynekmlcoch.cz/informace/medicina/nemoci-lecba/menierova-nemoc-menieruv-syndrom-priznaky-projevy-lecba-diagnostika-vysetreni>.
• Vertigo Academy. Endolymfatický hydrops : Ménièrova choroba a Ménièrův syndrom [online]. [cit. 2010-05-20]. <http://www.vertigoacademy.cz/zavrat/priciny>