Meniere disease

Meniere disease (idiopathic endolymphatic hydrops)
- Impaired resorption of endolymph causes accumulation
- Epidemiology
  - Females
  - Older adults
- Clinical features
  - Meniere triad
    - Episodes lasting from minutes to hours
    - 3 yes 1 no
    - Yes: Sensorineural HL
    - Yes: Repeated attacks of vertigo
    - Yes: Tinnitus
    - No: No neurological signs
- Diagnosis
  - Criteria
    - >1 episode that lasts 20 minutes to 12 hours
    - Low-mid frequency SN hearing loss
    - Tinnitus
- Treatment
  - Avoid triggers (stress, alcohol, caffeine)
  - Low sodium diet
  - Rehabilitation
  - Bed rest
  - Drugs
    - First generation antihistamines
    - Histamine analogues
    - Gentamycin in ear – destroy vestibule
  - Surgery
    - Labyrinthectomy
    - Sacculotomy
    - Vestibular neurectomy‎