Define Meniere’s disease &  its etiology, clinical features & management.


Definition:-
It is caused by dilation or swelling of endolymphatic sac, affecting the drainage of endolymph or other tissue in vestibular system of inner ear.
An abnormal inner ear fluid balance .
Etiology:- There are many etiological factors that cause of this disease
• Idiopathic
• Any type of allergy
• Any head injury
• Previous middle ear infection
• Excessive use of alcohol, smoking
• Viral disease
• Malabsorption & blockage of duct & sac.
• Dilation in space
• Rupture of membrane
• Genetic disorder
The exact cause of this disease is not known, but it is believed to be related gross distension of endolymphatic system or excessive endolymph in inner ear.
Types of Meniere’s disease:-
• Cochlear disease:- It is fluctuating , progressive sensorineural hearing loss associated with tinnitus & aural pressure in absence of vestibular .
• Vestibular disease:- It is occurrence of episodic vertigo associated with aural pressure but no cochlear symptoms.
Clinical manifestations:-
Some sign & symptoms are occur during this disease that are following-
• Vertigo, dizziness headache
• Tinnitus , roaring sound
• Hearing loss
• Fullness of ear
• Photophobia
• Balancing disorder
• Nausea& vomiting
Diagnostic investigation:-
• History collection about the medical, genetic, personal history.
• Physical examination of nausea, vomiting & vertigo.
• CT- Scan of inner scan
• MRI (Magnetic Resonance Imaging)
• Audiogram tympanotomy
• Complete blood collection , ESR
• Neurological examination

Medical management:-
• Avoidance of alcohol, smoking & use low salt diet and also avoid aspirin.
• Administer antivertigo medicine e.g. Meclizine,
• Administer diuretic to help reduce amount of fluid.
• Administer anti- inflammatory medication e. g. corticosteroids.
Surgical management:-
• Endolymphatic sac decompression:- An incision makes behind the ear & expose mastoid bone & process the mastoid & identify facial nerve & bone cover endolymphatic sac is open .
• Labyrinthectomy:- Opening of inner ear to drainage of endplymph .
• Chemical labyrinthectomy:- Fill streptomycin in inner ear to destroy the nerve ends for balance.
Key words :-
• Endolymph sac
• Mastoid bone
• Middle ear
• Hearing loss
• Audiometry

Author: Swati Bankolia