Ménière’s disease

Avoiding permanent damage: informing comprehensively, treating early

Ménière’s disease – or Ménière’s syndrome – is a rare disease affecting both the auditory and vestibular system. This leads to an accumulation of endolymph fluid in the inner ear (endolymphatic hydrops), more precisely in the Eustachian tube. This congestion is the result of an imbalance between the production and transport of the fluid, which is regularly exchanged. 

Our specialists at Schoen Clinic have extensive experience in treating Ménière’s disease. The aim is to alleviate your discomfort or improve your quality of life. 

Causes & symptoms

Ménière’s disease: Causes of the disease

The cause of this disorder has not yet been fully clarified. Psychological factors play just as important a role as inflammation and other organic influences.

Ménière’s disease: Symptoms of the condition

The accumulation of fluid leads to a dysfunction of the sensory cells in the auditory and vestibular organs. The damage causes vertigo and generally low-frequency tinnitus (<90Hz). In addition, it triggers hearing loss of the low-pitched sounds, which regenerates in the initial stage of the disease. As the frequency of seizures increases, hearing deteriorates permanently, especially in the low frequency range. The attacks are accompanied by nausea and vomiting. 

In addition, many patients describe a feeling of pressure in the affected ear.

Diagnostics

Diagnosis: How we determine Ménière’s disease

It is difficult to make an unequivocal diagnosis, especially in the early stages. The disease can be preceded by an isolated occurrence of individual symptoms, which very often persists as a single phenomenon.

The diagnosis can therefore only be made on the basis of the clinical progression of the symptoms. Recurrent symptoms can show the way forward here. Targeted functional examinations using magnetic resonance imaging reveal hydrops during an attack and can limit the diagnosis.

Verified and probably Ménière’s disease

Ménière’s disease is considered to be verified after two or more vertigo episodes lasting at least 20 minutes, accompanied by proven hearing loss and tinnitus or ear pressure. Other organic causes must be excluded here. 

If all three criteria are not met, it is usually a ‘probable’ or ‘possible’ Ménière’s disease.

Secondary, psychologically-triggered vertigo attacks very often occur as a result of the recurring, fear-inducing vertigo attacks, which are experienced as life-threatening. In most cases, the person affected cannot distinguish this anxiety dizziness from a real Ménière’s disease attack.

Differentiation from other diseases

For a precise diagnosis, it is important to clearly distinguish this from other diseases. For example, a vertigo migraine may progress in a very similar manner to a Ménière’s disease attack. Sole endolymph fluctuation with isolated hearing loss in the low frequency range, pressure and a feeling of fullness in the ear without dizziness should be distinguished from real Ménière’s disease.