ENT - Meniere's disease Flashcards

1
Q

What is the triad of Meniere’s disease

A

Hearing loss
Vertigo
Tinnitus

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2
Q

What is the pathophysiology of Meniere’s disease?

A

Ménière’s disease is associated with the excessive build-up of endolymph in the labyrinth of the inner ear, causing a higher pressure than normal and disrupting the sensory signals.

This increased pressure is called endolymphatic hydrops.

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3
Q

Presentation

A

Unilateral hearing loss, vertigo and tinnitus

Vertigo:

  • Comes in episodes
  • 20m-hours
  • Not triggered by movement/posture

Sensorineural hearing loss:

  • Typically fluctuates at first
  • Gradually becomes more permanent
  • Low frequencies first usually

Tinnitus - also typically occurs with vertigo attacks before eventually becoming more permanent

Other Sx:

  • A sensation of fullness in the ear
  • Unexplained falls (“drop attacks”) without loss of consciousness
  • Imbalance, which can persist after episodes of vertigo resolve
  • Spontaneous nystagmus (usually unilateral) during acute attack
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4
Q

Diagnosis of Meniere’s disease

A

Clinical based on signs and symptoms

Refer to ENT for diagnosis

Need audiometry to assess hearing loss

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5
Q

Management of Meniere’s disease

A

Acute attack STM of Sx:

  • Prochlorperazine
  • Antihistamines (e.g., Cyclizine, promethazine)

Prophylaxis - betahistine

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