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Meniere's disease
Menieresdiseaseaffectstheinnerear,whichistheseatofhearingandbalance.Duringanattack, thepersonexperiencesvertigoasensationthattheyortheworldaroundthemismoving.They feeldizzyandsick,theirhearingisdominatedbyahissingorroaringsound,andoneorbothears feelfulltoburstingpoint. Menieresdiseasemaydevelopslowlyovertime,withagraduallossofhearing,orsuddenlywitha vertigoattack.Attackscanbeminutesorhourslong.Afterwards,thepersonmightexperiencemild deafnessandfeelunsureoftheirfooting.Asthediseaseprogresses,theepisodesofvertigo becomelessfrequentandthedeafnessmoresevere. Balance and hearing are affected ItisthoughtthatMenieresdiseaseiscausedbyabuild-upoffluidinsidetheinnerear.This interruptsmessagestothebrainfromboththebalanceandthehearingnerves,causinglossof controlofthesefunctions. Balancetheinnerearcontainsaseriesofcanalsfilledwithfluid.Thesecanalsareat differentangles.Whentheheadismoved,therollingofthefluidinsidethesecanalstells thebrainexactlyhowfar,howfastandinwhatdirectiontheheadismoving.Information fromthesecanalsispassedalongtothebrainviathevestibular(balance)nerve.Ifthe brainknowsthepositionofthehead,itcanworkoutthepositionoftherestofthebody. Hearingthecochleaisthesnail-shapedhearingorganintheinnerear,whichisalso filledwithfluid.Thisfluidmovesinresponsetosounds.Messagesarepassedalongthe hearingnervetothebraintotelluswhatwearehearing.Thebuild-upoffluidassociated withMenieresdiseasedisturbsthehearingnerveendings,causinghearingfluctuationand eventuallypermanentdamage.

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A range of symptoms ThesymptomsofMenieresdiseaseinclude: Loss of clear hearingorlossofabilitytodistinguishspeechorlocationofsound. Loss of balance (vertigo)thesurroundingsseemtospin.Somepeoplefeeladegreeof motionsickness,whileothersmightevenvomitorexperiencediarrhoea. Noises in the ear (tinnitus)describedashissing,roaringorringing,oracombination ofsounds.Thetinnitusiseitherunrelentingorfadesinandout.Thevolumeofthetinnitus isvariabletooandoftenincreasespriortoaMenieresattack. Hearing lossusuallyinthelowfrequenciesandincludesafuzzy,unclearqualityto sounds. Ear fullnessasensationthattheearisunderpressureandclosetobursting. Sensitivity to noisesomenoisescanhurttheears,whileothernoisesmightbequiet butofaparticularpitchthatcausespain.

Oftenoneortwosymptomswillbemorenoticeablethanothers,butadiagnosisofMenieres diseaseincludesvertigo,hearingloss,tinnitusandafeelingofpressure. Diagnosis ManyofthesymptomsofMenieresdiseasecanalsobecausedbyotherconditions,sodiagnosisof theconditionofteninvolvesfirstrulingoutothermedicalpossibilities. ThereisnospecifictestforMenieresdisease,butdoctorsusearangeoftestsincombinationto helpdiagnosethedisorder.Theseinclude: Hearing teststotestifhearinglossisspecifictoyourinnerear. Low frequency lossthisisanindicatorofMenieres.

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Electronystagmography (ENG)measuresinvoluntaryeyemovementwhilebalanceis putunderstress. Magnetic resonance imaging (MRI)maybeusedtoruleoutdisordersofthecentral nervoussystemthatmaybeconfusedwithMenieresdisease,suchasacousticneuroma, Arnold-Chiarimalformationandmultiplesclerosis.

Non-surgical treatment ThereisnocureforMenieresdisease.Treatmentgenerallyfocusesonmanagingsymptomsand preventingordecreasingthenumberofattacks.Wherepossible,theaimistoconservehearing andreducebalanceproblems. Non-surgicaloptionsinclude: Medicationtocontrolvertigo,nauseaandvomiting,andreduceanxietyandfluid retention. Lifestyle changesstressmanagement,dietarychanges,quittingsmoking. Pressure pulse devicestohelprelievethebuild-upofpressureandreducevertigofor peoplewhosesymptomsdonotrespondtomedicaltherapy. Chemical ablationanantibioticisusedtoreduceordestroytheremainingbalance (vestibular)functionsoftheinnerearsosignalsarenolongersenttothebrain.

Surgery is a last resort Ifyouareexperiencingsevereattacksofvertigoandmedicaltreatmentsdonthelp,surgerymay beconsidered.Thismayincludeproceduresthat: Alterthebuild-upoffluidinyourinnerear(endolymphaticsacprocedures) Destroythebalancemechanismoftheinnerear(vestibularnervesectionorvestibular neurectomy)theseareseriousoperationsthatmaycarryariskofhearingloss,can temporarilydisruptyourbalanceandmayrequireaperiodofrehabilitation.

Rehabilitation Ifyouexperiencebalanceproblemsbetweenattacks,youmaybenefitfromdoingexercisesand activitiesthathelpyourbodyandbrainregaintheabilitytoprocessbalanceinformationcorrectly. Thisiscalledvestibularrehabilitationtherapy. Managing the condition Yourdoctorcanhelpyoutofindwaystomanageyoursymptomsandhelpreducethefrequency andseverityofattacksassociatedwithMenieresdisease.Somesuggestionsinclude: Recognise the warning signs of an attacksitorliedownimmediatelywhenyoufeel dizzy. Rest duringandafterattacks,beforereturningtoregularactivities. Avoid triggersthatmakeyoursymptomsworse,includingsuddenmovement,bright lights,watchingtelevisionorreading. Beware of losing your balancegoodlighting,anevenwalkingsurfaceanduseofa walkingstickcanhelpyoutomaintainstabilityandavoidafall. Avoid driving a car or operating heavy machineryifyouexperiencefrequent episodesofvertigo,asthiscouldleadtoanaccidentandinjury. Use a hearing aidifyouexperiencehearingloss. Eat regular mealsanevenintakeoffoodanddrinkthroughoutthedaycanhelp regulateyourbodyfluids. Reduce your salt (sodium) intakeeatingtoomuchsaltmayincreasethefluidinyour innerearandmakeyoursymptomsworse.Aimtoeatnomorethan1,000mgofsodium perday.Mostfreshfoodsarenaturallylowinsalt,butprocessedfoodsoftenarenot. Avoid caffeine and alcoholexcessiveamountsofcaffeine(intea,coffee,chocolateand coladrinks)oralcoholcanconstrictyourbloodvesselsandmakeyoursymptomsworse. Quit smokingavoidingnicotinemaylessentheseverityofyoursymptoms. Join a support groupoffersunderstandingandinformationtohelpyoulivewithand manageyourcondition.Yourdoctorcanrecommendasupportgroupinyourarea.

Where to get help Yourdoctor Hearingspecialistear,noseandthroatspecialist(ENT)

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Audiologist MenieresSupportGroupofVictoriaTel.(03)97839233

Things to remember

Menieresdiseaseaffectstheinnerear,theseatofhearingandbalance. Theexactcauseofthediseaseisunknown. Treatmentoptionsincludemedication,dietandlifestylechangesand,asalastresort, surgery.

Want to know more? GotoMoreinformationforsupportgroups,relatedlinksandreferences. This page has been produced in consultation with, and approved by:

Meniere'sSupportGroup

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Meniere'sdisease

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