Meniere's Disease

Article information

J Korean Med Assoc. 2008;51(11):1007-1015
Publication date (electronic) : 2008 November 30
doi : https://doi.org/10.5124/jkma.2008.51.11.1007
1Department of Otorhinolaryngology, Yonsei University College of Medicine, Korea. wsleemd@yumc.yonsei.ac.kr
2Department of Otorhinolaryngology, Seoul National University College of Medicine, Korea. jawonkoo@snubh.org

Abstract

Hydrops of the endolymphatic space in the inner ear deteriorates hearing and balance function. This idiopathic syndrome of endolymphatic hydrops is Meniere's disease and is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. For the pathophysiologic mechanisms of the episode, the progression of the hydrops leads to ruptures in the membranes separating endolymph from perilymph, producing a sudden increase in potassium concentration in the perilymph. Recurrent episodes may interfere with routine daily activities and sometimes accompany sudden drop attacks, so called Tumarkin's otolithic crisis, which may lead to serious injuries. Life style modification, low salt diet and prescription of diuretics have been traditionally tried in order to relieve endolymphatic hydrops. Surgical and destructive treatment options are necessary in selected intractable patients depending on the frequency of vertigo, severity of hearing loss and the possibility of bilateral involvement. However, a large proportion of these patients shows a spontaneous cure of vertigo with the aggravation of hearing loss (burnt out stage) over time. The goal of treatment is trying not to make the patient worse than this natural course of disease.

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Article information Continued

Table 1

Diagnostic guidelines of Meniere's disease (American Academy of Otolaryngology-Head and Neck Surgery, 1995)

Table 1