Ménière’s disease is a chronic disorder of the inner ear that affects balance and hearing, often causing recurrent episodes of vertigo, fluctuating hearing loss, tinnitus, and a sensation of fullness in the affected ear. Unlike BPPV, which causes brief positional vertigo, Ménière’s disease leads to prolonged and unpredictable attacks that can last from 20 minutes to several hours, significantly impacting daily activities and emotional well-being.

The exact cause of Ménière’s disease remains unclear, but it is believed to result from abnormal fluid accumulation in the inner ear, a condition known as endolymphatic hydrops. This excess fluid disrupts normal balance and hearing signals sent to the brain. Contributing factors may include genetic predisposition, autoimmune responses, viral infections, allergies, and abnormalities in inner ear fluid regulation.

Symptoms typically begin in one ear, though bilateral involvement may occur over time. Vertigo attacks are often severe and accompanied by nausea, vomiting, sweating, and difficulty standing or walking. Hearing loss in Ménière’s disease is usually sensorineural and fluctuating in the early stages but may become permanent with disease progression. Tinnitus is often described as roaring or buzzing, and ear fullness may precede vertigo episodes.

Diagnosis is based on clinical criteria, patient history, and audiological testing. Hearing tests demonstrate characteristic low-frequency sensorineural hearing loss in early disease. Additional tests such as vestibular function assessments and imaging may be used to exclude other causes of similar symptoms.

Management focuses on reducing the frequency and severity of attacks and preserving hearing. Lifestyle modifications, including salt restriction, adequate hydration, and avoidance of caffeine and alcohol, play a critical role. Medications may be prescribed to control vertigo, nausea, and fluid balance. In refractory cases, intratympanic injections or surgical interventions may be considered.

Ménière’s disease is a long-term condition requiring ongoing ENT follow-up. While there is no definitive cure, appropriate management allows many patients to achieve symptom control and maintain an acceptable quality of life.