This book describes Meniere’s Disease, Diagnosis and Treatment and Related DiseasesMeniere's Disease is a disease of the inner ear which is characterized by the triad of episodic vertigo (giddiness), tinnitus (buzzing sound in ear) and progressive hearing loss.It is more common in adults between 30-60years of age and in men more than women.It usually occurs in one ear.No one knows the exact cause of Meniere's Disease.It is believed to be due to distension of the membranous labyrinth with increased pressure and fluid in the endolymph of the inner ear.The possible triggers of this condition may be:1. Middle ear infection,2. Head injury3. Upper respiratory tract infection4. The effect of aspirin,5. Smoking6. Alcohol7. Caffeine8. SaltSymptoms:The classical triad of symptoms is:1. Recurrent bouts of vertigo of varying degrees which may last from hours to days.Recurrences may be as often as 1 week to several years.2. Slow progressive loss of hearing in one ear or rarely in both ears starting at low pitch sounds first.3. Unilateral tinnitus (buzzing sound in one ear), sometimes in both earsDiagnosis is by:Audiometry shows impairment of hearingMRI scan of the head - to exclude a tumor of the eighth cranial nerve (vestibulocochlear nerve)Initial treatment:1.Acute attacks are treated symptomatically with injections of stemetil, maxolon, dimenhydrinateOther treatments:1. Oral stemetil, maxolon, dimenhydrinate2. Mild diuretic3. Vitamin B64. Antihistamines,5. Anticholinergics,6. Corticosteroids orally or injection of steroid medication behind the eardrum7. Bed rest8. Stress reduction.9. Low-sodium diet.10. Avoid caffeine, alcohol and cigarettesSurgery:Surgery is only required if the above treatment does not control the vertigo1. Decompression of the endolymphatic sac may help to relieve symptoms.2. Permanent surgical destruction of the balance part of one ear may be done where the disease is severe and affects one ear.a. Chemical labyrinthectomy: a drug (such as gentamicin) that can cause destruction of the balance portion of the inner ear is injected into the middle ear.b. Vestibular neurectomy where section of the nerve to the balance portion of the inner ear is done surgicallyc. Surgical removal of the inner ear (labyrinthectomy).TABLE OF CONTENTIntroductionChapter 1 Meniere’s DiseaseChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 VertigoChapter 8 TinnitusEpilogue