Ménière disease (or idiopathic endolymphatic hydrops) is an inner ear disorder and as such can affect balance and hearing.
One or both ears can be affected. The chief symptoms are:
- vertigo (often attacks which can be incapacitating)
- hearing loss
- a sensation of fullness in the ears
- Tullio phenomenon occasionally experienced 8
The American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium set criteria for diagnosing Ménière disease, most recently revised in 1995 1:
- certain: a definite disease with histopathological confirmation
- definite: requires two or more definitive episodes of vertigo with a hearing loss plus tinnitus and/or aural fullness
- probable: only one definitive episode of vertigo and the other symptoms and signs
- possible: definitive vertigo with no associated hearing loss
Although considered to be idiopathic, there is an association with inner ear effusions and endolymphatic hydrops.
The role of imaging is controversial 2, but improved spatial resolution in CT and MRI is likely to show where the endolymphatic flow is impaired.
Reduced visualisation of the saccular duct and endolymphatic sinus are featured 6. At high-resolution temporal bone CT, the vestibular aqueduct is either small or not visible at all, in contrast to the congenital large vestibular aqueduct syndrome.
High-resolution MRI can show lack of a visible endolymphatic duct and sac.
History and etymology
It is named after the French physician Prosper Ménière (1799-1862) who first recognised vertigo as an inner ear disorder.
- 1. Beasley NJ, Jones NS. Menière's disease: evolution of a definition. J Laryngol Otol. 1997;110 (12): 1107-13. Pubmed citation
- 2. De Sousa LC, Piza MR, Da Costa SS. Diagnosis of Meniere's disease: routine and extended tests. Otolaryngol. Clin. North Am. 2003;35 (3): 547-64. Pubmed citation
- 3. Tanioka H, Kaga H, Zusho H et-al. MR of the endolymphatic duct and sac: findings in Menière disease. AJNR Am J Neuroradiol. 1997;18 (1): 45-51. AJNR Am J Neuroradiol (abstract) - Pubmed citation
- 4. Kobayashi M, Fukaya T, Noda M. The endolymphatic sac in patients with Ménière's disease: correlation between the MRI and the surgical findings. Acta Otolaryngol. 2001;120 (8): 955-9. Pubmed citation
- 5. Miyashita T, Toyama Y, Inamoto R et-al. Evaluation of the vestibular aqueduct in Ménière's disease using multiplanar reconstruction images of CT. Auris Nasus Larynx. 2012;39 (6): 567-71. doi:10.1016/j.anl.2011.11.005 - Pubmed citation
- 6. Yamane H, Sunami K, Iguchi H et-al. Assessment of Meniere's disease from a radiological aspect - saccular otoconia as a cause of Meniere's disease?. Acta Otolaryngol. 2012;132 (10): 1054-60. doi:10.3109/00016489.2012.680980 - Free text at pubmed - Pubmed citation
- 7. Nidecker A, Pfaltz CR, MatéFi L et-al. Computed tomographic findings in Ménière's disease. ORL J. Otorhinolaryngol. Relat. Spec. 1985;47 (2): 66-75. Pubmed citation
- 8. Ishizaki H, Pyykkö I, Aalto H, Starck J. The Tullio phenomenon in patients with Menière's disease as revealed with posturography. (1991) Acta oto-laryngologica. Supplementum. 481: 593-5. Pubmed