Ménière disease

Ménière disease (or idiopathic endolyphatic 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
  • tinnitus
  • sensation of fullness in the ears

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: definite disease with histopathological confirmation
  • definite: requires two or more definitive episodes of vertigo with 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 endolyphatic hydrops.

The role of imaging is controversial 2, but improved spatial resolution in CT and MRI is likely to show where endolymphatic flow is impaired.

CT

Reduced visualisation of saccular duct and endolymphatic sinus are features 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 aquaeduct syndrome.

MRI

MRI is used to to exclude alternative diagnoses such as vestibular schwannoma or other cerebellopontine angle lesions, and superior semicircular canal dehiscence.

High resolution MRI can show lack of a visible endolymphatic duct and sac.

It is named after the French physician Prosper Ménière (1799-1862) who first recognised vertigo as an inner ear disorder.

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Article information

rID: 24267
System: Head & Neck
Section: Pathology
Synonyms or Alternate Spellings:
  • Idiopathic endolyphatic hydrops
  • Ménière's disease

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