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