Introduction
Diseases of the inner ear are pretty varied, but they are challenging to study due to the difficulties in understanding the pathogenetic mechanism of disease development. It is particularly difficult to determine the causes, conditions, and nature of non-inflammatory diseases, which lead to severe consequences such as partial or complete hearing loss. Given this result of the course of the disease, more and more attention is being paid to the mechanisms controlling the physiological constancy of the inner ear. Among the diseases that occupy a special place in the system of such diseases is Ménière’s Syndrome.
Overview
Ménière’s syndrome is a relatively rare disorder that can cause symptoms that significantly affect the quality of life. It is associated with the development of vertigo and tinnitus on the affected side (Wu et al. 463). As the symptoms increase, neurosensory hearing loss develops, the nature of which is not fully understood. Due to research limitations, the disease’s exact mechanism is unknown, and its origins and causes remain multifactorial. In addition, Ménière’s syndrome is often combined with other diseases, so accurate diagnosis remains challenging.
Etiology
Although the exact etiology of Ménière’s syndrome remains unknown, there are reliably investigated risk factors for the disease. Zhang et al. (116) list the presence of a viral infection as such risks since the symptoms can be treated with acyclovir. Potential causes can also be autoimmune diseases, among which rheumatoid arthritis, allergic reactions, and diseases related to water-salt imbalance are prominent. Similar conclusions are reached by Liu et al. (808), who also point to the autoimmune character of the disease. The disease is likely a combination of factors, so symptomatic treatment and environmental exposure are most relevant for patients with Ménière’s syndrome.
Symptoms
The symptoms associated with Ménière’s syndrome are commonly considered from two perspectives. First, there are direct lesions of the vestibular apparatus: hearing loss and vestibular hypofunction (Zhang et al., 119), axonal atrophy and myelin sheath damage (Liu et al., 808), migraine and occasional hearing loss (Morita et al.). Second, there is electrical signal conduction: hyperkalemia and hyponatremia (Wu et al. 465), changes in permeability for ions, impaired ion, and plasma flow (Liu et al. 809). Patients most commonly cite episodic vertigo (Wu et al. 464), partial or complete hearing loss (Basura et al. 2; Marieb and Hoehn 594), and tinnitus in their complaints (Zhang et al., 120). This combination of symptoms makes it necessary to look for new ways of diagnosis and treatment because the symptomatology is similar to other diseases.
Differential Diagnosis
Ménière’s syndrome should be investigated based on a detailed medical history and analysis of concomitant risk factors associated with the medical history. Moreover, attention should be paid to the duration of the observed symptoms (Wu et al. 465) and the existing preconditions that patients associate with them. Liu et al. (809) point out that it is difficult to diagnose without additional detailed studies of vestibular and auditory function. A similar conclusion was reached by Morita et al., who considered the relevance of rotating chair function studies. The differential diagnosis of the syndrome should be carefully studied together with such diseases as otosclerosis, neuronitis, thrombosis of the main arteries of the ear, and others. Due to the similarity of the symptoms (tinnitus, vertigo), the diagnosis should be cross-referenced with the mandatory use of clinical laboratory and instrumental diagnostic capabilities.
Treatment
Treatment of Ménière’s syndrome is based on preventing the effects of the main symptoms (nausea, tinnitus, dizziness). Along with partial or complete hearing loss come a significant deterioration in the quality of life, so treatment combines both medication and physical therapy (Basura et al. 9). Current guidelines suggest following a few key recommendations regarding the medications used as stated in Table 1.
Table 1. Recommendation for Medication Treatment
The benefits of physical therapy are only reported in clinical guidelines, which raises the question of its relevance. Nevertheless, such methods include vestibular therapy (VR), a recommendation for controlling balance function (Basura et al. 36). VR has the advantage of teaching the patient stability in gaze, limb movement, and synchronized movements. An extreme case of treatment for Ménière’s syndrome is surgery, which sometimes can show significant improvement. General treatment recommendations include controlling diet, creating a comfortable environment, teaching balance, and restoring sleep patterns.
Conclusion
Ménière’s syndrome is a severe condition that significantly impairs quality of life due to symptoms of vertigo and partial or total hearing loss. The disease is accompanied by symptoms similar to otosclerosis/ neuronitis and other inner ear diseases; therefore, a differential diagnosis involving instrumental and clinical investigation methods is necessary for confirmation. Treatment recommendations include a medication option, and the benefits of physical therapy and dietary control are reported.
Works Cited
Basura, Gregory J et al. “Clinical Practice Guideline: Ménière’s Disease.” Otolaryngology–Head And Neck Surgery: Official Journal Of American Academy Of Otolaryngology-ad And Neck Surgery, vol. 162, 2020, pp. 1-55.
Liu, Yupeng et al. “Current status On Researches of Meniere’s Disease: A Review.” Acta oto-laryngologica, vol. 140, 2020, pp. 808-812.
Marieb, Elaine N. and Katja Hoehn. Human Anatomy & Physiology, 11th ed. London: Pearson, 2018.
Morita, Yuka et al. “Is Vestibular Meniere’s Disease Associated With Endolymphatic Hydrops?.” Frontiers in Surgery, vol. 7, 2020,
Wu, Vincent et al. “Approach to Ménière Disease Management.” Canadian Family Physician Medecin De Famille Canadien, vol. 65, 2019, pp. 463-467. Web.
Zhang, Sulin et al. “Meniere Disease Subtyping: The Direction Of Diagnosis And Treatment In The Future.” Expert Review of Neurotherapeutics, vol. 22, 2022, pp. 115-127.