Ménière’s disease is a chronic vestibular (inner ear) disorder. The inner ear influences both hearing and balance. It is named for the French doctor Prosper Ménière (18 June 1799 – 7 February 1862), who, in 1861, first identified and described the symptoms of the medical condition that now bears his name. These symptoms include fluctuating hearing loss, episodic vertigo, a sensation of ear fullness, and tinnitus. Typically, only one ear is affected.
Many disorders have similar characteristics so, in 1995, the American Academy of Otolaryngology-Head and Neck Surgery refined the diagnosis as follows:
Probable Ménière’s disease: One definitive episode of vertigo and audiometrically documented hearing loss, tinnitus, and fullness of the affected ear
Definite Ménière’s disease: Two or more definitive spontaneous episodes of vertigo (20 minutes or longer), hearing loss, tinnitus, and aural fullness in the affected ear. Dizziness can appear after a long period of tinnitus or muffled hearing. They may appear so suddenly that the person loses balance and falls.
The disorder is physically caused by a buildup of a fluid called endolymph in the compartments of the inner ear, called the labyrinth. The labyrinth contains the organs of balance (the semicircular canals and otolithic organs) and hearing (the cochlea). The labyrinth has two sections: the bony labyrinth and the membranous labyrinth, the second of which is filled with endolymph which, in the balance organs, stimulates receptors as the body moves. The receptors then send signals to the brain about the body’s position and movement. In the cochlea, fluid is compressed in response to sound vibrations, which stimulates sensory cells that send signals to the brain.
This excess fluid–beyond the normal amount of fluid that exists in the cochlea–affects both balance and hearing. The cause of the fluid buildup is not yet completely understood. Some researchers believe it is related to the same blood vessel constrictions that lead to migraine headaches; others say it might be due to an autoimmune condition, a viral infection, an allergic reaction, or head trauma. Ménière’s appears to have a hereditary component, so there may be a gene mutation connected to the regulation of endolymph fluid.
Sources: David S. Haynes, M.D., FACS, Chair of Hearing Health Foundation (HHF)’s Council of Medical Trustees and Professor of Otolaryngology, Neurosurgery and Hearing & Speech Sciences, Vanderbilt University Otology Group; National Institute on Deafness and Other Communication Disorders (NIDCD)