What is Ménière’s Disease?

• Ménière's disease (MD) is a disorder of the inner ear that is characterized by episodes of feeling like the world is spinning (vertigo), ringing in the ears (tinnitus) hearing loss, and a feeling of fullness in the ear.
• Typically, only one ear is affected initially; however, over time both ears may become involved.
• Episodes generally last from 20 minutes to a few hours. The time between episodes varies.
• The hearing loss and ringing in the ears can become constant over time.

How Ménière’s Disease is Diagnosed?

Definitive criteria for Ménière’s disease:

• Two or more spontaneous episodes of vertigo, each lasting 20 minutes to 12 hours
• HEARING ASSESSMENT: Audiometrically documented low- to medium-frequency sensorineural hearing loss in the affected ear on at least on one occasion before, during, or after one of the episodes of vertigo.
• BALANCE ASSESSMENT: Fluctuating aural symptoms (hearing, tinnitus, or fullness) in the affected ear.

Treatment Options for Ménière’s Disease?

MEDICATION:
The doctor will prescribe you medication to reduce nausea, anxiety, for allergies, vertigo, balance problems.

DIET:
Patients with Ménière’s disease are advised to intake a low salt diet.

PHYSICAL THERAPY:
Physical therapy helps in retraining balancing system.

COUNSELLING:
The psychological distress caused by the vertigo and hearing loss may worsen the condition in some people. Counseling may be useful to manage the distress.

INTRATYMPANIC GENTAMICIN INJECTION:

• Gentamicin is a medication intended to purposefully damage the inner ear to stop dizziness or vertigo in Ménière’s disease.
• Intratympanic Gentamicin injection is the preferred therapeutic option for patients in whom conservative management including lifestyle modifications and oral medications failed to treat Ménière’s disease.
• This is also known as Transtympanic Gentamicin injection.

PROCEDURE:

• Gentamicin is injected through the eardrum using a narrow needle.
• The drug is left in the middle ear for 30 minutes, and then allowed to drain out through the Eustachian tube into the throat.
• The procedure is simple and can be performed in the outpatient basis under local anesthesia with manageable recovery time.

What to Expect after Intratympanic Gentamicin Injection?

• The patient may experience a disequilibrium sensation beginning approximately 3-5 days after injection, which reaches to peaks in 10-14 days after injection and fades over the course of several more weeks.
• The presence of this reaction is an indicator of treatment response.
• Intratympanic Gentamicin injection achieves control of vertigo in 80%-90% of patients.