HealthLinks Charleston May/June 2022

74 | www. Char l es tonPhys i c i ans . com | www.Hea l thL i nksChar l es ton . com Its name is tricky to pronounce, its arrival is signaled by vertigo and tinnitus and, as it progresses, its presence tends to worsen with hearing loss, imbalance and the sensation of internal ear pressure. It is known as Ménière’s disease, one of the lesser chronic disorders but a condition that can lead to complete hearing loss in one or both ears. “Ménière’s disease is considered treatable but not curable and, in most cases, affects only one ear,” said Dr. Kathryn Miles Jackson, doctor of audiology and owner of Upstate Hearing & Balance in Greenville. “It can occur at any age but usually starts between young and middle-aged adulthood, and attacks can be brought on by certain triggers, such as dietary factors.” Patients with suspected Ménière’s disease are encouraged to keep a food diary because items such as caffeine, chocolate and alcohol can induce attacks. But diet is only one part of the puzzle. Fluid retention, which produces a buildup of pressure in one of the spaces in the inner ear, is thought to be the cause of Ménière’s disease. Consumption of too much sodium can cause an accumulation of fluid in the body. And although there is no sodium recommendation specifically for patients with Ménière’s, following the American Heart Association’s ideal limitation of 1,500 mg a day may be helpful to manage attacks. Stress also plays a part in the onset of the disease, as does the sudden feeling of vertigo – which makes you feel like you’re spinning, dizzy and lightheaded with a loss of balance – plus a condition known as tinnitus. “Tinnitus is a buzzing or ringing in the ears,” Dr. Jackson said. “Patients with Ménière’s disease often describe this sensation as a rushing or roaring sound.” Some treatments aren’t particularly attractive. For example, an injection of an antibiotic medication, gentamicin, into the middle ear reduces the effectiveness of the balance organ for that ear, alleviating vertigo attacks but possibly making the hearing loss even worse. “But the patient may find benefit for hearing using either a hearing aid or a cochlear implant once the disease has run its course,” Dr. Jackson said. Alternatively, a steroid, such as dexamethasone, may be injected into the middle ear space to help control vertigo attacks. “It is considered less effective than gentamicin but is less likely to cause further hearing loss,” Dr. Jackson said. “When these MÉNIÈRE’S DISEASE: DON’T IGNORE THE SIGNS By L. C. Leach III