Clinical presentation and symptoms
The primary manifestation of the disease is the classic triad of symptoms, which includes:
- Systemic vertigo, invariably accompanied by nausea and vomiting.
- Partial or complete unilateral hearing loss of a temporary or fluctuating nature.
- Persistent tinnitus.
This clinical picture requires careful analysis, as the hearing loss in this pathology affects specific frequency ranges.
Pathogenesis of the disease
The development of the pathology is based on impaired normal functioning of the inner ear structures. Key pathogenetic links:
- Changes in the osmotic pressure of the endolymph.
- Development of endolymphatic hydrops.
- Rupture of the barrier separating the endolymph and perilymph.
It is these processes that trigger attacks and lead to characteristic neurological and auditory disorders.
Diagnosis and audiometry
To quantify hearing impairment and perform differential diagnosis, audiometry is used—an examination of the hearing threshold for air and bone conduction at various frequencies.
Unlike presbycusis or other forms of hearing loss, Meniere's disease is characterized by a specific low-frequency perception impairment. Bedside tests also help distinguish conductive hearing loss from sensorineural hearing loss, but instrumental examination is required to identify the true cause.
Approaches to treatment and prevention
Therapeutic measures for this condition are aimed at relieving acute manifestations and preventing further relapses. Main directions:
- Use of specialized medications to relieve vertigo.
- Performance of intratympanic perfusions (direct drug administration into the tympanic cavity).
- Long-term prevention through the administration of betahistine.
Meniere — Meniere's means Less hearing at Low frequencies: endolymphatic hydrops damages the barrier and produces the triad (vertigo, tinnitus, hearing loss).
Class and exam questions
What are the main manifestations of Meniere's disease?
The disease presents with the classic triad: systemic vertigo with nausea and vomiting, unilateral fluctuating hearing loss, and tinnitus.
What audiometric changes are characteristic of this pathology?
Meniere's disease is typically characterized by perception impairment specifically at low frequencies, unlike presbycusis, where the high-frequency range is affected.
What is the basis of the disease's pathogenesis?
The pathogenesis is associated with altered osmotic pressure of the endolymph, leading to endolymphatic hydrops and rupture of the barrier between the endolymph and perilymph.
What treatment and prevention methods are used?
Medications are used to relieve vertigo, intratympanic drug perfusions into the tympanic cavity are performed, and betahistine is prescribed for prevention.
What else to study on this topic
- Features of performing and interpreting audiometry in various types of hearing loss
- Differential diagnosis of Meniere's disease and vestibular neuritis
- Anatomical and histological features of vestibular schwannoma
- Causes and clinical manifestations of sudden sensorineural hearing loss
- Symptomatology and diagnostic rules for lesions of the central auditory pathway in the brainstem
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