Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

129 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Have meniere's disease. Experiencing fluctuating hear loss, dizziness and vertigo. Required treatment?

Answered by
Dr.
Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2565 Questions

default
Posted on Thu, 21 Feb 2013 in Ear, Nose and Throat Problems
Question: I am struggling in between several diagnosis, and in the meantime have had absolutely no relief. For approximately 2 years, I have been experiencing mild off and on dizziness, often related to my migraines. But, at one point was diagnosed with Meniere's, even though I did not have extreme vertigo spells, just minor dizziness. At that point 2 years ago, my hearing was declining. So, I was put on a diuretic in hopes that it would treat the Meniere's. Since then, I still have mild dizziness, but nothing severe. But, my hearing has contiued to decline and around 6 months ago, I started to experience severe ear clogging and congestion /fullness and the worst is the ringing. It sounds like a loud ring or white noise. To the point where I can't hear anything else. It's literally driving me crazy and severely depressed. I want to pop my ears all of the time. Everything is severely muffled. It feels like pressure. As if i am stuck at a bad altitude on the airplane. And, the ringing happens on top of that. When I talk on the phone, it sounds like a tunnel sound in my ear. Loud noises hurt. I got a second opinion from another ENT who said that I didn't have Meniere's, but I in fact had only Hydrops. Due to the frequency levels I am hearing. And, he put me on a Vasodilator, I have been on it for 6 days. I am looking for any help, I am desperate.
doctor
Answered by Dr. Sumit Bhatti 3 hours later
Hi,

Thank you for your query.

1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus
d. Fullness in the ear
There is usually nausea and vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. This condition develops suddenly or slowly and erratically and varies from person to person.

2. You should get a PTA (Pure Tone Audiogram) to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially (Audiogram sloping to left).

3. Get a Tympanogram done to check middle ear pressures and Eustachian Tube Function (ETD). If this Impedance Audiogram is normal, it may be Meniere's as it does not affect the middle ear.

4. If this Impedance Audiogram is abnormal, then a trial of medication should be taken for three to four weeks. If this does not work, a myringotomy with a grommet insertion may help. Steroid drops can be given for a longer duration through this ventilation tube.

5. An MRI Scan is usually advised in a patient of vertigo so as not to miss any major cause, one of which is an Acoustic Neuroma. I must emphasize that Acoustic Neuromas are rare and almost 99% of MRIs are normal. Acoustic Neuromas also have other symptoms depending upon their size. They are benign and extremely slow growing. MRI Scans display anatomy and form, not function. If you do go in for an MRI, try a 3 Tesla Scan. It may pick up the subtle changes due to Meniere's Disease in the inner ear.

6. The Eustachian tube is normally in a collapsed state. It can be voluntarily opened by yawning, swallowing, chewing gum, blowing your nose or performing the Valsalva maneuver. A Tympanogram and eardrum examination is more important.

7. Meniere's disease should normally respond to a salt restricted diet, acetazolamide (diamox) and betahistine (Vertin).

8. What is your exposure to occupational noise and loud music / earphones / mobile phones? Exposure to loud noise is also a leading cause for tinnitus. How severe is your tinnitus on a scale of 1 to 10? Do you have nystagmus (abnormal eye movements)? Is the tinnitus pulsatile (matching with the heartbeat)? Does you have any other co-existing conditions including anemia (low hemoglobin), thyroid problems, blood pressure fluctuations, cervical spondylosis, nasal problems besides ETD or history of head injury? Have migraine associated vertigo and superior semicircular canal dehiscence syndrome been ruled out?

9. If steroids have not controlled your Tinnitus and your middle ear is normal (no eustachian dysfunction), then you may try Caroverine (Tinnex) injectable or capsules. Use of hearing aids may help mask tinnitus.

I hope that I have answered your query. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Lab Tests ,  

Recent questions on  Tinnitus

doctor1 MD

Hello, I have been experiencing dizziness upon waking. I find this very odd. I will open my eyes, still horizontal and get dizzy. It will last a minute or two. I will get out of bed, And it may continue or may not. I have stood up and side stepped, still dizzy. Or have been fine. This has started over the past week. I do have tinnitus, and have had vertigo in the past. I have had my hearing and eyes checked recently; testing was normal. I am wondering if all this is associated with menopause, or if the veritigo has returned with a new twist. I am a 51 year old female. I would appreciated any input. I have used serc in the past for vertigo which helped the nauseous feelings. But am at a loss as to why I m getting dizzy before rising in the morning. Any input would be appreciated.

doctor1 MD

I was in a car accident 1 year ago with whiplash injuries and also swooshing sounds in left ear. The neck stuff appears to be better but the noise I hear in my ear happens currently when I change positions or move my head or jaw one way. The ENT did ct and MRI and mra and found nothing wrong. I did find out I have a floppy eardrum. Why do I have this pulsatile tinnitus? Could it be coming from my neck still? I read about diet soda? Can the caffeine or aspartame cause this?

doctor1 MD

I have had fluncuating vertigo, imblance, hypercusis, tinnitus...etc for over 10 yrs. Have seen neurologists, ENT..etc.... have tried numerous medications to no avail. Drs have suggested vestibular migraine or possibly meieres disease, although I don t have any actual hearing loss so they have steered away from that. Given the long term nature of my condition, I have been inclined over the past few yeasr to just suffer through it. Most of the time the problem is moderate and non-disabling..however...at least 5 -10 days out of the month I can barely function..dizzy, can t keep blanace, can t tolorate sounds...etc. Do you have any suggestions? Thank you, Alan.

doctor1 MD

I recently was diagnosed with bronchitis. I was given antibiotics for it and I have been taking them for about three days. The period of time (2 weeks) I suffered from the symptoms of the bronchitis without going to the doctor included the development of a whooshing or rushing sound in my left ear. I ve been looking this symptom up and I was wondering whether or not it was pulsatile tinnitus and if this symptom is common with upper respiratory tract infection.

doctor1 MD

Dr. Eni My daughter is home now and is still nauseous, and dizzy with stomach pain, but is doing better since receiving CBD anally. No reason was ever found for her symptoms. If you have a theory please share it wth me.

doctor1 MD

I've seen 2 doctors. I've also emailed back and fourth with Dr. XXXXXXX XXXXXXX on this site. My symptoms are ringing in the left ear. Low grade headache and nausea. I've had these symptoms for more than 3 weeks now. Sometimes the headache goes...

doctor1 MD

I am hoping someone can help me and shed some light on something that has been going on for me. I feel lost and scared. About 9 months ago, I started getting this dizzy sensation when tilting my head to the right but only sometimes. And sometimes,...