Overview
Four Patterns, Four Different Mechanisms
These conditions can all affect hearing or balance, but the pattern of symptoms usually separates them.
These conditions can all affect hearing or balance, but the pattern of symptoms usually separates them. Ménière disease results from endolymphatic hydrops: excess endolymph within the membranous labyrinth of the inner ear. Pressure and distortion in this fluid-filled system disrupt both vestibular and cochlear function. The result is a characteristic combination of spontaneous, episodic vertigo, fluctuating low-frequency sensorineural hearing loss, tinnitus, and a sense of a blocked or full ear. Hearing may improve between attacks early in the disease, which can mislead patients into thinking the problem has resolved. Definite Ménière disease requires all of the following: - At least two spontaneous vertigo episodes lasting 20 minutes to 12 hours - Audiometrically documented low-frequency sensorineural hearing loss in the affected ear - Fluctuating aural fullness or tinnitus - Reasonable exclusion of another diagnosis Probable disease is considered with one vertigo episode plus the relevant audiometric findings when the full definite-disease pattern has not yet been established. A nurse should not label every episode of dizziness as Ménière disease; sudden hearing loss, neurological findings, medication effects, infection, and other vestibular disorders...