Meniere's disease is a condition characterized by episodes of vertigo, ringing in the ears (tinnitus), fluctuating levels of hearing loss, a sensation of fullness of pressure in the ear and ear pain. Some patients experience nausea and vomiting. The attacks can be very serious and debilitating - forcing the patient to lie down. With each episode, the symptoms may vary in duration and intensity. Vertigo may last for twenty minutes or more than two hours. Patients may continue to feel "off-balance" for several days. Onset of attacks is unpredictable. The symptoms may occur as often as once a day or just once a year.

The National Institutes of Health estimates about 100,000 Americans are diagnosed with Meniere's disease each year. Symptoms typically develop between 20 and 50. Men and women are equally affected. In most cases, only one ear is involved.

Treating Meniere's

There is no cure for Meniere's disease. The initial treatment usually involves dietary changes (low-salt diet and avoidance of caffeine and alcohol) and use of diuretics to reduce fluid retention. Patients are also given information about the condition. With time, about 70 percent of patients experience a gradual improvement in most symptoms, but may retain some degree of hearing loss.

For the remaining 30 percent of patients, treatments are less certain. Some experts recommend administration of small doses of the antibiotic, gentamycin, directly into the inner ear. The medication is toxic to the sensory cells that control balance, but doesn't affect the tissues responsible for hearing. By damaging the balance structures, the treatment helps control vertigo.

Surgery may be recommended when patients aren't helped by any other treatment. There are different surgical approaches. Some procedures can control vertigo, but damage the hearing structures, leading to hearing loss. A procedure called vestibular neurectomy cuts the nerve from the balance structures in the ear. It preserves hearing, but is associated with more surgical risk.

The Meniett® Device

One of the structures in the inner ear, the membranous labyrinth, is filled with a fluid, called endolymph. As the body moves, the fluid hits nerve receptors inside the membranous labyrinth, sending signals to the brain about the position of the body. If the drainage channels for this fluid become blocked or the body produces too much fluid, excess levels can build (a condition called hydrops). Pressure builds up within the membranous labyrinth, causing the structure to balloon out. Many health experts believe the symptoms of Meniere's disease are caused when the wall of the membranous labyrinth ruptures, causing the endolymph to mix with another type of inner ear fluid, called perilymph.

A device, called the Meniett® Low-Pressure Pulse Generator, addresses the problem of excess fluid in the inner ear by using gentle pulses of low-pressure air. The air is delivered from a small, portable pack through a tube placed in the ear canal. The pressure pulses pass through a tiny ventilation tube in the eardrum (similar to that used for children with frequent ear infections) and into the middle ear. From here, the pressure travels to the inner ear, where researchers believe the force displaces the excess fluid.

Each treatment with Meniett consists of three cycles of one minute of pulsed pressure followed by 40 seconds of pause. Ear, Nose & Throat Specialist, George Gates, M.D., says the sensation of the pulses of low air pressure is less than that felt while ascending or descending in an airplane.

The Meniett is only available by prescription. Although the device was approved several years ago, use is now catching on. Research shows the device works for about two-thirds of patients with Meniere's disease and is safe for short and long-term use. Gates cautions Meniett is only helpful for vertigo and will not improve hearing loss or tinnitus. The device is not recommended for patients with perilymph fistula (an abnormal opening in the fluid-filled space of the inner ear), acoustic neuroma, brain tumor, cochlea damage or low-pressure hydrocephalus.

For information about Meniett®, log onto http://www.meniett.com, or call (877) 966-3350.

For general information on Meniere's Disease:

American Academy of Otolaryngology - Head and Neck Surgery

American Hearing Research Foundation

The National Institute on Deafness and Other Communication Disorders