7) MENIERE’S DISEASE

Synonym-
Meniere's disease is a disorder characterized by Triad:

Endolympatic Hydrops
• Endolymphatic hydrops is most consistently found in the

• When saccular distension is extensive, it can distort the utricle and semi
circular canals in the vestibule and saccular membrane can bulge out to
contact the foot plate of stapes either directly or via fibrous adhesions

• Male female
• Uni-lateral/ bilateral-

Other predisposing factors

•
•

•
• Associated with Cochlin gene- Ch6 short arm mutation

Vertigo

vagal disturbances like diarrhoea, cold ,sweat, pallor,

bradycardia
 Hearing loss

Tinnitus Low pitched roaring type

Sense of
fullness of ear

DILATED SACCULE AND UTRICLE

Drop crisis / TUMARKIN crisis-

Tullio phenomenan–

• Otoscopy :
• Nystagmus- seen only during attack . Fast component is towards
the healthy ear

• TFT –

• Pure tone audiometry:

• Recruitment test-
• SISI >
• Speech audiometry

• Glycerol test : (it’s a dehydrating agent when given orally reduces

endolymphatic pressure)
Hearing will

• Caloric tests: Canalparesis

• Electocochleography −
(Summation potentioal/ action potential) > is diagnostic

Variants of Menieres disease

• Cochlear :
• Vestibular hydrops :
• Lermoyez syndrome( reverse menieres ) –

Secondary Menieres

• Congenital and acquired syphilis

• Pagets disease
• Post stapedectomy
Treatment:
General measures

Acute attack Chronic phase

Vestibular
sedatives

Vasodilators

Other drugs 1. Atropine 1. Diuretics

Intratympanic Gentamycin therapy

• Gentamycin .

• INTRATYMPANIC STEROIDS

SURGICAL
Conservative procedures( preserve hearing)

Destructive procedure ( Destroy hearing)