Meniere's Disease

Question 1

What is Meniere’s disease?

Answer 1

Disorder of the membranous labyrinth and cochlear fluids

Too much endolymph

Question 2

What specific symptoms are associated with Meniere’s disease?

Answer 2

• Hearing loss
• Tinnitus*
• Vertigo
• Aural fullness*

***Need to have tinnitus or aural fullness to be diagnosed with Meniere’s disease

Question 3

How does decreased hearing present?

Answer 3

• Low-frequency SNHL
• Hearing flucuates, can recover quickly at first but then takes months
• Ear eventually burns out, flat 50 to 60 dB SNHL

Question 3

How does decreased hearing present?

Answer 3

• Low-frequency SNHL
• Hearing flucuates, can recover quickly at first but then takes months
• Ear eventually burns out, flat 50 to 60 dB SNHL

Question 4

How does tinnitus present?

Answer 4

• Roaring, whooshing, waterfall, etc

- Low-frequency

Question 5

How does aural fullness present?

Answer 5

Report increase as attack nears

Question 6

How does vertigo present?

Answer 6

• Sensation of spinning or falling
• Nausea and vomiting
• Attack can last for hours - lingering unsteadiness for days
• Two or more episodes must last for at least 20 minutes to be diagnosed with Meniere’s disease

Question 7

What is the difference between classifying Meniere’s as a syndrome vs disease?

Answer 7

• Syndrome: classic symptoms are a result of KNOWN etiologies (allergies, hypothyroidism)
• Disease: etiology is idiopathic

Question 8

What has histology shown when looking at Meniere’s?

Answer 8

Increase in volume of endolymph within the scala media

Question 9

Meniere’s disease is usually … unilateral or bilateral? Occurs most often in what population?

Answer 9

Unilateral

Older adults, rarely occurs in children

Question 10

First episode of Meniere’s typically occurs during what age?

Answer 10

Middle age

Question 11

Treatment for Meniere’s disease includes …

Answer 11

• Medication
• Changes in lifestyle (reduce stress, reduce salt intake, limit use of alcohol, caffeine, and nicotine)
• Surgery
• Vestibular exercises and therapy may help vertigo attacks

Question 12

Meniere’s presentation in otoscopy

Answer 12

WNL, not a middle ear or outer ear problem

Question 13

Meniere’s disease effect on tympanometry

Answer 13

WNL, not a problem of the middle ear or outer ear

Question 14

Meniere’s disease affect on acoustic reflexes

Answer 14

Consistent with degree of hearing loss, absent if SNHL greater than 50 dB

Question 15

Meniere’s disease effect on OAEs

Answer 15

Consistent with degree of hearing loss
DPOAEs; absent if greater than 40 dB
TEOAEs: absent if greater than 30 dB

Question 16

Meniere’s presentation on the audiogram

Answer 16

• Low frequency SNHL
• See rising hearing loss
• Eventually becomes a flat 50 to 70 dB SNHL, burned out ear