Rapid Review: Meniere Disease

Meniere Disease

• Patient will be complaining of episodic low-frequency hearing loss, tinnitus with aural (ear) fullness, and vertigo lasting one to eight hours
• Diagnosis is made clinically
• Most commonly caused by too much inner ear endolymph and increased pressure within the inner ear
• Treatment is low salt diet, diuretics (HCTZ + triamterene)

Example: A patient complains of a 6-month history of tinnitus and vertigo that occurs with nausea, vomiting and a sensation of “ears full of water.” These symptoms occur intermittently in attacks at a frequency of once or twice a week. He denies head trauma, headache, photophobia or focal neurologic deficits. Otoscopic examination reveals no external auditory canal or tympanic membrane abnormalities. Weber and Rhinne testing support unilateral sensorineural hearing loss. In addition to diet changes, trigger avoidance, and diuretics, which of the following is strongly recommended for the initial management of these symptoms?