Tuesday, 2 January 2018

5 Treatments For Meniere's Disease, Diagnosis And Advice

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Meniere's disease is a disorder of the inner ear that causes episodes in which you feel as if you're spinning (vertigo), and you have fluctuating hearing loss with a progressive, ultimately permanent loss of hearing, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear. In most cases, Meniere's disease affects only one ear.


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How A Diagnosis Is Carried Out

The diagnosis of Meniere's disease is primarily made from the history and physical examination. Tinnitus  or ear fullness (aural fullness) need to be present to make the diagnosis An audiogram is helpful to show a
hearing loss, and to rule-out other abnormalities. It is often helpful, if it can be done safely, to have an audiogram during or immediately following an attack of vertigo. This may show the characteristic low frequency hearing loss. As the disease progresses hearing loss usually worsens. The disease can be diagnosed with any of the following methods :

  • Balance Tests : Balance tests are done to test the function of your inner ear. People who have Meniere’s disease will have a reduced balance response in one of their ears. The balance test most commonly used to test for Meniere’s disease is electronystagmography (ENG). In this test, you will have electrodes placed around your eyes to detect eye movement. This is because the balance response in the inner ear causes eye movements.During this test, both hot and cold water will be pushed into the ear. The water causes the balance function to work. Your involuntary eye movements will be tracked. Any abnormalities can indicate a problem with the inner ear..
  •  Hearing Test : An audiometric examination (hearing test) typically indicates a sensory type of hearing loss in the affected ear. Speech discrimination (the patient’s ability to distinguish between words like “sit” and “fit”) is often diminished in the affected ear.
  • The auditory brain stem response (ABR), a computerized test of the hearing nerves and brain pathways, computed tomography (CT), or magnetic resonance imaging (MRI) may be needed to rule out a tumor occurring on the hearing and balance nerve. Such tumors are rare, but they can cause symptoms similar to Ménière’s disease.
  •  Electrocochleography (ECoG) : This test looks at the inner ear in response to sounds. It might help to determine if there is an abnormal buildup of fluid in the inner ear, but isn't specific for Meniere's disease.
  •   Posturography : This computerized test reveals which part of the balance system — vision, inner ear function, or sensations from the skin, muscles, tendons and joints — you rely on the most and which parts may cause problems. While wearing a safety harness, you stand in bare feet on a platform and keep your balance under various conditions.


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Treatments For Meniere's Disease

Meniere’s disease is a chronic condition with no cure. However, there are a variety of treatments that can help with your symptoms, ranging from medication to surgery for the most severe cases.

  1. Air pulse generator: in some patients, periodic delivery of small air pulses transmitted through a tube placed in the ear drum has had some variable success.
  2. Motion sickness medications, such as meclizine or diazepam (Valium), may reduce the spinning sensation and help control nausea and vomiting.
  3.  Gentamicin, an antibiotic that's toxic to your inner ear, reduces the balancing function of your ear, and your other ear assumes responsibility for balance. The procedure, which can be performed during local anesthesia in your doctor's office, often reduces the frequency and severity of vertigo attacks. There is a risk, however, of further hearing loss. 
  4.  Surgery : Most people with Meniere’s disease don’t require surgery, but it’s an option for those who have severe attacks and haven’t had success with other treatment options. An endolymphatic sac procedure is done to help decrease the production of fluid and promote fluid drainage in the inner ear. A vestibular nerve section procedure cuts the nerve that connects the ear to the brain, which reduces vertigo while preserving hearing. A labyrithecotomy is done when there is total hearing loss in the ear. This surgery removes the entire inner ear, which removes the balance and hearing function from that ear.
  5.  Hearing aid : A hearing aid in the ear affected by Meniere's disease might improve your hearing. Your doctor can refer you to an audiologist to discuss what hearing aid options would be best for you.

Others Things That Are Recommended -

  • Stress management: Stress and anxiety are both linked to Meniere's disease, but both can be a cause and symptom of the disease. Learning how to manage and identify stressors can bring relief. It may be beneficial to try relaxation or meditation techniques. 
  •  Quit Smoking: Many people who suffer from Meniere's disease and who regularly smoke report weakened symptoms after quitting.
  •   Salt intake: Salt helps the body to retain water, so reduce intake of sodium-rich beverages and foods.
  •  Decrease caffeine intake : Caffeinated beverages can make symptoms like tinnitus worse, so it is best to decrease the amount of this stimulant in your diet.
  • Smaller meals: More experts are proving there are greater benefits to the body if you consume five to six smaller meals throughout the day instead of three larger meals. This dietary pattern can also improve symptoms of Meniere's disease by keeping the metabolism moving and bodily fluids regulated. Similarly, opting for a healthier lifestyle can decrease the amount and severity of Meniere's disease symptoms.
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Author: Richard Smith