Condition- Meniere's Disease

Question 1

What is Meniere’s Disease?

Answer 1

A syndrome/ disease characterised by:

• episodic sudden onset of vertigo
• low-frequency hearing loss (in the early stages of the disorder)
• low-frequency roaring tinnitus
• sensation of fullness in the affected ear.

Question 2

What is the latin name for Meniere’s Disease?

Answer 2

Endolymphatic hydrops

Question 3

List some of the potential causes of Meniere’s Disease…

Answer 3

• Recent Viral infection
• Genetic Predisposition
• Autoimmune Disease
• Allergy
• Syphyllis
• Accoustic or physical trauma
• Lyme Disease
• Hypothyroidism
• Stenosis of internal auditory canal

Question 4

Describe the pathophysiological process behind Meniere’s disease…

Answer 4

1. Overproduction or impaired absorption of endolymph
2. Excessive endolymphatic fluid pressure –> distension and rupture of Reissner’s membrane
3. Inner Ear disruption => sensorineural hearing loss, tinnitus, vertigo

Question 5

Describe the presentation of patient’s with Meniere’s

Answer 5

• Sudden onset vertigo- lasting from mins to hours
  
  • Nausea
  • Vomitting
• Intermittent fluctuating hearing loss which becomes constant later on
• Unilateral roaring tinnitus
• Aural fullness

Question 6

List some of the signs of Meniere’s Disease upon physical examination

Answer 6

• Positive ROMBERG’S TEST: Swaying or falling when asked to stand with feet together and eyes closed
• FUKUDA’S stepping test: Turning towards the affected side when asked to march in place with eyes closed
• May see nystagmus and inability to tandem walk

Question 7

What would be the result of comparing pure-tone air and bone conduction (vibrational sense when comparing air and bone conduction)

Answer 7

• BONE CONDUCTION: bypasses outer and middle ear and tests cochlea and auditory nerve
• AIR CONDUCTION: looks at outer ear and middle ear conduction
• Expect to see same conductivity because outer and middle ear are unaffected and it is a sensorineural problem