Meniere's Disease

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Meniere's Disease
Meniere's Disease
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Video: Meniere's Disease - What Happens in the Inner Ear? 2023, February
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Meniere's disease

Meniere's disease (Meniere's disease) is a disease of the inner ear. The inner ear has a complex structure. It includes the organ of equilibrium and the cochlea, which are filled with fluid and are in communication with one another. With Menière's disease, there is an increased accumulation of fluid (hydrops) and a temporary increase in pressure in the inner ear. Those affected suffer from seizure-like, recurring dizziness, hearing impairment and tinnitus. The causes have not yet been clarified.

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What are the symptoms of Menière's disease?

The following symptoms occur, among others:

  • Tinnitus
  • Dizzy spells
  • Hearing loss

The symptoms are often present at the same time. There is a feeling of pressure in the ear. Noises in the ears and hearing loss are mostly unilateral and can affect both ears over time. The dizziness is usually accompanied by nausea and vomiting and lasts for different lengths of time, from minutes to hours. Nystagmus (rhythmic, involuntary movements of the eyeball) can also appear. The course is not predictable. Repeated seizures can occur at different intervals - for example after days, weeks or months.

In the course of the disease, hearing loss usually occurs, which initially improves between attacks, but persists over time. One consequence of the increasing destruction of the inner ear is uncertainty when walking, which also persists. On the other hand, the severity and frequency of dizzy spells often decrease over the years and can stop.

How is the diagnosis made?

In the course of the diagnosis, it is clarified whether it is actually Menière's disease. The type, duration and frequency of the attacks as well as the symptoms provide the doctor with information. Any triggers for dizziness or ringing in the ears are also clarified. Various physical examinations, hearing and balance are performed.

The special examination methods include:

  • Creation of a nystagmogram. Using a special procedure and electronic recording, spontaneous eye movements (eye tremors) that occur in an acute attack of Menière's disease are registered.
  • Audiometry / audiogram. To test the hearing function or electrocochleography (ECochG) to test the function of the inner ear.
  • Glycerol test. To determine any additional fluid (hydrops) in the inner ear.

In addition, examinations of the cervical spine, blood, various internal and / or neurological examinations, etc. may be necessary.

How is the therapy carried out?

The treatment of Menière's disease starts with the symptoms. In acute cases, bed rest is prescribed. The drug treatment is based on the individual (acute) situation of the patient. It is done by:

  • Antivertiginosa (medication for severe dizziness with nausea, e.g. betahistine),
  • Cortisone (for the acute situation)
  • Sedatives (tranquilizers e.g. diazepam),
  • Diuretics (water medicines)
  • Antiemetics (drugs used to suppress nausea and vomiting).

In addition, the doctor can recommend, for example, a low-salt diet and a regular rhythm of life and include measures to better deal with stress in the treatment. Since the disease has a massive impact, psychotherapy may also be carried out - for example for accompanying anxiety states.

Further interventions are considered in severe cases:

  • Injection of aminoglycosides (certain antibiotics, such as gentamicin) into the middle ear. Using local anesthetics and aminoglycosides, sensory cells of the equilibrium nerve are switched off.
  • Saccotomy (sac decompression). Surgical intervention in the inner ear to prevent or relieve fluid accumulation.
  • Neurectomy of the vestibular nerve. During this procedure, the auditory balance nerve is severed. This is only done when the inner ear function has already been lost.

Whom can I ask?

The contact persons are primarily specialists in ENT and the family doctor.

Doctors from various disciplines are also involved in the diagnosis and therapy process, e.g. for emergency medicine (in acute cases) or neurology, etc.

Psychotherapists can also be involved.

How are the costs going to be covered?

The costs for diagnosis and therapy are usually covered by the responsible health insurance company. Your doctor will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible. You can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Visit a Doctor: Costs and Deductibles. You can find information on costs for a hospital stay under What does a hospital stay cost?

When making use of psychotherapy, full cost coverage is possible in the health insurance institutions' own or contractually bound institutions, as well as in institutions that are subsidized by the public sector. In these cases, there is the option of paying a deductible. Otherwise, you have the option of applying for a subsidy from the health insurance company if you are undergoing psychotherapy with a resident psychotherapist. If this is approved, the health insurance provider will reimburse you for part of the fee paid to the psychotherapist.

For information on the respective provisions, please contact your health insurance provider, which you can find on the social security website.

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