Ménière's disease

Ménière's disease is a disorder of the inner ear. It is not life-threatening but it can greatly reduce the life quality of the affected person. The inner ear, which is a complex paired organ located in the temporal bone of the skull. The inner ear consists of cochlea (auditory organ) and three semicircular canals (vestibular statokinetic system). Both cochlea and the vestibular system are filled with a fluid known as the endolymph, which allows their function. Ménière's disease affects both organs.


The exact cause of Ménière's disease is unknown. The mechanism of its origin lies in the endolymph. The endolymph accumulates and this causes an increase of local pressure in the inner ear resulting in disorders of audition and balance. The reason of endolymph accumulation is not known, it is probably an imbalance between its production and absorption. The risk of disease is increased by smoking, unhealthy diet and high cholesterol, i.e. factors leading to atherosclerosis. Repeated infections of the inner ear may have similar effect.


The symptoms are related to functions of the affected organs. The patient suffers from hearing problems in one or both ears. The hearing disorder usually gradually worsens and if the affection is bilateral, the process may result in total deafness. In addition, the patient has problems with keeping balance and suffers from dizziness accompanied with nausea and vomiting. The dizziness occurs in bouts that last from dozens of minutes to several hours. The person may also feel pressure in the affected ear or unpleasant sounds such as whistling or ringing (tinnitus). It is believed that Vincent van Gogh, the famous painter, suffered from Méničre's disease, which forced him to cut off his own ear to relieve the unpleasant symptoms.


The patient suffering from the symptoms should be examined by an otolaryngologist. In addition to the audiometry, it is advisable to perform a computed tomography or magnetic resonance imaging of the head to exclude the acoustic neuroma (also known as vestibular schwannoma), which can cause similar troubles.


Ménière's disease can not be cured, but at least it is usually possible to suppress the symptoms. The dizziness is treated with various anti-inflammatory drugs and antiemetic agents. If the conservative approach is not efficient, it is possible to perform a surgical intervention of certain range. The most radical method is targeted destruction of the affected labyrinth (when the disease is unilateral) resulting in disappearance of dizziness but also in unilateral deafness. There are also experiments with less radical surgery where doctors try to ensure drainage of endolymph and prevent its accumulation.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Contact: jiri.stefanek@seznam.cz
 Sources: basic text sources