Ménière's disease is a condition that affects the hearing and balance functions of the inner ear. Patients suffer from a combination of vertigo (the sensation of movement when you are stationary), tinnitus and hearing loss, often with a sensation of pressure in the affected ear. The symptoms come as attacks, and can be disabling for a number of days. Individual experiences vary enormously with some patients having only a few attacks per year and others getting many attacks each month.
The exact cause of Ménière's disease is not known, but studies have shown that the inner ears of affected individuals suffer from similar patterns of fluid accumulation. One compartment of the inner ear, which contains a fluid called endolymph, becomes swollen. It is believed that this excess fluid accumulation leads to the attacks of symptoms found in patients with Ménière's disease.
Diagnosis has always relied on a detailed consultation by a doctor experienced in the diagnosis of inner ear disorders as the symptoms can often be similar to other conditions. Treatment should of course be tailored to the individual’s symptoms and needs. Control of symptoms is often possible with dietary modification and medication designed to combat the vertigo and aid the dispersal of the excess fluid in the inner ear.
For those individuals whose attacks continue, or whose symptoms are most severe, several surgical options are available. Generally these rely on procedures that reduce the balance function in the ear so that the vertigo is less disabling. Many of these procedures carry significant risks to the hearing and residual balance function of the inner ear, and are reserved for the most difficult cases.
A new form of treatment using a Low-Pressure Pulse Generator is now available from St Anthony’s. Mr David Selvadurai, a Consultant Ear Surgeon at St Georges Hospital, has brought this technology to St Anthony’s having experienced its use in Leicester and in Sydney, Australia. The device (called a Meniett), which is battery operated and portable, allows the patient to treat themselves by pushing a small earpiece (like an ear plug ) into their ear. The Meniett then applies a very gentle air pressure wave to the inner ear in a carefully controlled pattern. This cycle takes about five minutes and is repeated several times a day during the initial period of treatment. It is necessary to have a small operation (which can be done under local anaesthetic) to insert a grommet into the affected ear before starting treatment. This allows the pressure wave to be transmitted from the device to the inner ear.
Use of this device is thought to “milk” the excess endolymph out of the inner ear and reduce the frequency and severity of attacks. It does not work for everyone, but many patients experience significant long term relief with few side effects or drawbacks.
A fuller account of the device and its use is available at Meniett.com. Mr Selvadurai has a special interest in the treatment of all hearing and balance disorders and has regular clinics at St Anthony's.
To make an appointment with Mr Selvadurai please contact our Outpatient department on 020 8335 4678 / 9.
For further information on Meniere's Disease contact:
The Méniére's Society
The Rookery, Surrey Hills Business Park, Wotton, Dorking, Surrey RH5 6QT, United Kingdom.