Meniere’s Disease In India: Audiologists Hearing The Call


Meniere’s disease (Idiopathic endolymphatic hydrops) is an inner ear disorder characterized by recurrent vertigo, fluctuating hearing loss, tinnitus or ringing in the ear and a feeling of fullness or pressure in the ear. Fluid build-up in the inner ear creates pressure and causes damage to organs responsible for balance and hearing. This disease is named after the French physician Prosper Meniere who first described the condition in 1861. It is usually seen in young and middle aged adults. 75% of cases occur in 30-60 year olds but it can occur in anyone, even children. The disease is diagnosed by an audiologist through clinical examination and audiometry test.  The relapsing nature of the disease may affect balance, hearing and the patient’s quality of life.

The exact cause of Meniere’s disease is unknown, but it is believed that build-up of excess fluid in the inner ear and the body’s inability to reabsorb the fluid plays an important role in creating the symptoms. Meniere’s disease affects 2 out of 1,000 people in the world. Approximately 100,000 people develop this disease every year. People who are at greater risk include those who had middle or inner ear infection, respiratory infection, head injury, those with a history of allergies, smoking, alcohol use and taking certain medicines like aspirin.

The primary signs and symptoms of Meniere’s disease can be a combination of vertigo, hearing loss, tinnitus, sensitivity to loudness, impaired vision and feeling of fullness in the ear. A typical attack might start with a feeling of fullness in the ear, increasing tinnitus and hearing loss followed by severe vertigo which is often accompanied by nausea and vomiting. An attack might last for 20 minutes to four hours or even longer, after which signs and symptoms improve. Attacks often occur in cluster, for example you could have severe vertigo and only mild tinnitus or you could have mild vertigo, severe hearing loss and frequent tinnitus. Episodes could be frequent or there may be periods of remissions in between for weeks or months. The frequency, duration and severity of each episode vary, especially early in the disease. Although Meniere’s disease is considered a chronic condition, various treatment strategies can help relieve symptoms and minimize its long-term impact on patient’s life. An MRI is often suggested to rule out tumour of 8th cranial nerve.

The prevalence of hearing loss in India was estimated to be around 5.9 to 16.56 per cent. More than 5 million Indians suffer from hearing impairment. According to the WHO, India is among the countries that have the highest prevalence of hearing loss. It is estimated that there are more than 500,000 people affected by Meniere’s disease in India. The increasing number of cases is attributed to the increasing risk of air pollution, noise pollution and chemical toxicity.

The treatment of ear disorder in India dates back to the early fourth century through the use of Ayurvedic Medicine.  However, Audiology is relatively new only half a century ago. Audiologists are specialists that help in diagnosing and treating patients of Meniere’s disease and other hearing related damage. Audiology has grown exponentially during this short period of time and made significant progress in the treatment of hearing loss. A large proportion of audiologists in India are performing test, post-surgical rehabilitation for cochlear implants and hearing aid fitting in children as well as adults. However, the number of audiologist is not enough to help the growing number of people with hearing disability. There is a severe shortage of audiologist in the country. No matter how audiologists want to be part of the solution, the ratio between audiologist means each specialist should handle 20,000 patients a day which is impossible. Due to this shortage, many people with hearing disability go untreated. This is situation is impending the government’s hope of eradicating hearing impairment in the next 20 years.

Emotional instability, stress and improper diet are the common trigger factors for Meniere’s disease.  There are many ways from many cultures to treat Meniere’s disease. In Ayurveda in India the disease is believed to happen because of Vata and Pitta disorder. Excess heat (Pitta) can produce symptoms like vertigo, headaches and migraine while Vata can cause tinnitus or ringing in the ear. Ayurvedic treatments are very successful in treating Meniere’s disease and its accompanying symptoms since it produces balance from the root cause. Patients just need to follow certain diet, take Ayurvedic herbs and implement lifestyle changes.

In traditional Chinese medicine the ideas about the cause of Meniere’s disease has a direct link with the kidney (shen) and the endocrine system. Kidney qi weakens with age and hearing difficulty as well as failure in vision arises as a result. Chinese medicine treatment of Meniere’s disease is based on dealing with symptoms, eliminating condition of excess and tonifying the body in case of deficiency. The treatment aims to nourish yin, detoxify the kidneys and replenish the body. Taking special Chinese herbs, patent Chinese medicine such as Qiju Dihuang bolus, Guipi bolus, Fugui Bawei , Longdan Xiegan is recommended. Acupuncture and moxibustion are also helpful for alleviating the symptoms of tinnitus and vertigo.

In Western medicine treatment comprises of symptom management, medication, chemical ablation and surgery is considered. Medical treatments are aimed to reduce symptoms, prevent hearing loss and reduce the severity of attacks. Doctors recommend low sodium diets to help control water retention and reduce inner-ear fluid pressure. Doctors may prescribe medication to reduce vertigo and nausea to lessen the severity of the attack. To reduce fluid retention (diuretic) medications can also be prescribed. Noninvasive therapies and procedures, such as vestibular rehabilitation therapy, hearing aid and Meniett device can benefit people with Meniere’s disease. Surgery is needed if the symptoms are severe and the patient does not respond to other treatments. Surgical procedures may include endolymphatic sac procedures, vestibular nerve section or labyrinthectomy. People experiencing symptoms of Meniere’s disease should consider all options and seek medical advice to find out what particular treatment is right for them.