Meniere's Disease - Research Paper Example

 Meniere's Disease Introduction The human ear is affected by several conditions and diseases. These conditions and diseases include; ear infections, tinnutis, Meniere’s disease, otosclerosis, perichondritis, polychondritis, vestibular neuronitis, and barotrauma . This essay will examine Meniere’s disease, which, is a major disease that affects the human ear. Definition Meniere’s disease, also referred to as idiopathic endolymphatic hydrops is a term used to describe a set of episodic ear symptoms that encompass vertigo, hearing loss, tinnitus, as well as a sensation of fullness in the affected ear. The periods of attack usually last between 20 minutes to four hours. The hearing loss experienced is often fragmentary, taking place mainly at the time of vertigo attacks. Loud sounds may seem fuzzy and cause distress. Usually, the hearing loss encompasses mostly lower pitches even though; in the long run it affects tones of all pitches. If the disease lasts for several months or years, hearing loss may become permanent. Tinnitus and fullness of the ear are sporadic and are mostly dependent upon variations in hearing, although, they may occur during or just before attacks or become constant. Meniere’s disease is one of the major causes of dizziness that emanates from the inner ear. Additionally, in a majority of cases, only one year is affected, even though both ears can be affected. In terms of age, Meniere’s diseases mostly commences between the ages of 20 and 50 years. Otoscopic findings If a patient has Meniere’s disease, the otoscopy results do not indicate a condition. The two TM’s are visible and regular. Additionally, there are no abnormalities detected during the procedure. For a healthy ear, the TM appears translucent. Also, if a patient has Meniere’s disease, they might glum in the course of otoscopy as they do not appreciate the inadequacies of the test as well as the location of the defects. Case History Findings The American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNS) Committee on Hearing and Equilibrium published guidelines for the clinical diagnosis of Meniere’s disease in 1972, 1985, and 1995. The principles set out a definition for Meniere’s disease as a “recurrent, spontaneous episodic vertigo; hearing loss; aural fullness; and tinnitus. Either tinnitus or aural fullness (or both) must be present on the affected side to make the diagnosis.”(Meniere’s disease clinical presentation, n.d.) Degree of hearing loss The level of hearing loss in Meniere’s disease patients may vary depending on the patient. The degree can range from partial to total hearing loss. The degree of hearing loss is usually determined using; Gross evaluation of the hearing test, Rinne test, the Weber test, and audiologic testing (most accurate test). Gross evaluation of hearing is the easiest test, merely expedited by the examiner rubbing his hands gently around the suspected patient’s ear. The Rinne test is carried out using a 512MHz tuning fork. It normally shows that air conduction is superior to bone conduction. The Weber test, at the same time, is performed using a 512MHz tuning fork. In a healthy person, the sound should be experienced equally on both sides. An ear with an infection usually perceives a higher sound than the regular ear (Harris, 1999). Type of hearing loss A patient may experience partial or total loss of hearing based on the severity of the symptoms experienced. Type of tympanogram The type of tympanogram associated with a Meniere’s disease patient is a normal one. This is so because; Meniere’s disease does not affect the inner or the middle year. In medical terms, the tympanogram that is characteristic of Meniere’s disease is Type A. Acoustic reflex results Acoustic reflex results for Meniere’s disease shows Acoustic reflex decay results Typical reflex decay is elicited by patients with Meniere’s disease. Otoacoustic emission results For a patient with Meniere’s disease, the acoustic reflex will be less that 60 decibels. Auditory brainstem response results In case of Meniere’s disease, the masking noise is not sufficient in that an undermasked wave V is still present at latency similar to that of wave V without masking. Other pertinent test results There are myriad other tests that can be carried out in order to have adequate foolproof evidence when diagnosing someone with Meniere’s disease. These tests include; electrocochleography, electronystagmography, rotary chair test, vestibular evoked myogenic potential (VEMP), MRI of internal auditory canals, Lyme disease and syphilis serology, antinuclear antibody (ANA) test, anti-neutrophil cytoplasmic antibody, and rheumatoid test. Electrocochleography Abnormally large summating potential amplitude relative to the action potential amplitude is elicited in case of Meniere’s disease. Electronystagmography For patients with Meniere’s disease, this test result will be abnormal. Additionally, unilateral declined vestibular response in the affected ear is a common occurrence. Rotary chair test Dwindled gain, anomalous phase, and irregularity in the response. Vestibular evoked myogenic potential During the early stages of Meniere ’s disease, VEMP test shows increased amplitude, which is absent in later stages. MRI of internal audio canals For a case of Meniere’s diseases, the MRI of the audio canals appears normal. Lyme disease and syphilis serology A test for lime disease and syphilis serology turns normal in case of Meniere’s disease. Antinuclear antibody (ANA) test This test is mostly negative in several cases of Meniere’s disease, even though, a positive titer results in the presence of correlated autoimmune pathology. Anti-neutrophil cytoplasmic antibody test The ANA test is also negative for Meniere’s disease. Nevertheless, a positive titer may result in the case of autoimmune pathology. Rheumatoid factor This test is also mostly negative for Meniere’s disease, even though a positive titer may also result in the case of autoimmune pathology. Recommendations Meniere’s disease, being a very crucial disease as it affects the ear, should be mitigated before it gets to a severe stage. Also, for those people already suffering from Meniere’s disease, it is essential to expedite measures that will ensure they are comfortable. In order to prevent or to manage the disease, measures have to be put in place. These measures are; rehabilitation and hearing aids, self-care and home treatment, medication, as well as surgery. Rehabilitation and hearing aids Vestibular rehabilitation can help negate cases of vertigo, a major symptom of Meniere’s disease. These vestibular exercises help to account for the disparity in equilibrium between the two ears. The exercises are taught by a physical therapist. Loss of hearing can be mitigated by fitting one with hearing aids. Self-care and home treatment Tweaking of a variety of foodstuffs may help in reducing the amount of fluid in the inner ear and thus negate some of the symptoms. Foodstuffs that should be nipped include; salt, caffeine, chocolate, alcohol, and monosodium glutamate. Additionally, it is essential to drink a lot of water to help prevent fluid retention. Other lifestyle remedies that can be practiced include; resting in the case of vertigo attacks, quitting smoking (since nicotine aggravates symptoms of Meniere’s disease), regular eating (to help create fluid equilibrium in the body), evading allergens, and by managing stress and anxiety via psychotherapy or medication. Medication In cases where rehabilitation does give desired results, medication is necessitated. Medication for motion sickness may come in handy for mitigating symptoms of vertigo, nausea, and vomiting. Antiemetics may be prescribed for a patient with problems of nausea and vomiting. Diuretics may also be prescribed to reduce the amount of fluid. Medication can also be injected into the inner ear through the middle year to reduce indications of vertigo. Steroids can also be used to reduce symptoms of vertigo (Medifocus guidebook, 2010). Surgery Surgery may be pursued in severe cases of Meniere’s disease. An endolymphatic sac procedure is carried out to decrease the production of fluid and hence facilitate proper fluid drainage in the ear. A vestibular nerve section process is carried out to disconnect the nerve that connects the ear to the brain, while maintaining hearing, in order to negate vertigo. Labyrinthecotomy procedure is also carried out in case of total hearing loss. References Harris, J. P. (1999). Ménière's disease. The Hague: Kugler Publications. MediFocus guidebook: Meniere’s disease. (2010). Silver Spring, Md: MediFocus.com, Inc., Createspace. Meniere Disease (Idiopathic Endolymphatic Hydrops) Clinical Presentation. (n.d.). Retrieved May 6, 2015, from http://emedicine.medscape.com/article/1159069-clinical Read More