Meniere's disease is characterized by

(Veigo, tinnitus and hearing loss) Ref: Dhingra, 5th edition,Page 51,111 Meniere's disease (Endolymphatic hydrops) Characterized by tetrad of symptoms Episodic veigo 2.Flactuating sensorineural hearing loss (more severe in lower frequencies) A sensation of aural fullness Tinnitus (low- pitched and roaring) Hennebe's sign and Tulio's phenomenon is present Diagnosis Normal intact tympanic membrance with negative fistula test Recruitment is frequently present Impedence auidiometry is normal and there is no tone decay Sensory neural hearing loss , Rinne test is positive ,ABC is reduced in affected ear and Weber's is Lateralized to the better ear Radiography of the mastoid will be normal as views of the internal audiotry meati BERA - reduced latency of wave V Most sensitive and diagnostic is Electrochochleography Treatment Medicaltreatment Surgicaltreatment . Reassurance,bedrest,salt restriction,a lowcaffinediet avoidanceof nicotine. . Diuretics,labyrinthinesedative . Vasodilators . Streptomycintherapyisgivenin bilateralcasesto inducethe labyrinthinedamage Indicationsevereincapacitatingveigooinnitusoo preventfuher deteriorationofhearing (i)Decompressionofendolymphaticsacandinseionofa shuntbetween themembranouslabyrinthandsubarachnoidspace (ii)Vestibularneurectomy (iii)Totaltransmastoidlabyrinthectomy-whichrelievesveigoinover90% ofpatients (iv)Sacculotomy(Fick'soperation) Medicaltreatment Surgicaltreatment . Reassurance,bedrest,salt restriction,a lowcaffinediet avoidanceof nicotine. . Diuretics,labyrinthinesedative . Vasodilators . Streptomycintherapyisgivenin bilateralcasesto inducethe labyrinthinedamage Indicationsevereincapacitatingveigooinnitusoo preventfuher