ENT - Meniere's disease Flashcards
What is the triad of Meniere’s disease
Hearing loss
Vertigo
Tinnitus
What is the pathophysiology of Meniere’s disease?
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.
Presentation
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
Diagnosis of Meniere’s disease
Clinical based on signs and symptoms
Refer to ENT for diagnosis
Need audiometry to assess hearing loss
Management of Meniere’s disease
Acute attack STM of Sx:
- Prochlorperazine
- Antihistamines (e.g., Cyclizine, promethazine)
Prophylaxis - betahistine