1. Meniere’s disease
&
labyrinthitis
Presented by:
Jessica Faye G. Manansala

2. Anatomy of the inner ear
 The inner ear is house deep within the
temporal bone. The organs of hearing
(cochlea) and balance (semicircular canals), as
well as the cranial nerves VII (facial nerve) and
VIII (vestibulocochlear nerve)
 Cochlea and semicircular canals – are housed
in the bony of labyrinth.
 Bony labyrinth – surrounds and protect the
membranous labyrinth, which is bathed in a
fluid called perilymph

3.  Membranous labyrinth – it contains a fluid
called endolymph(posterior,superior , inferior
& lateral).
- Contains sensory receptor organs, arrange to
detect rotational movement.
- These receptor end organs are stimulated by
changes in the rate or direction of an
individual movement.

4. Organ of orti
 Snale shape bony tube about 3.5 cm long
with 2 and one half spiral turns
 The organ of orti called the end organ of
hearing, transform mechanical energy into
neural activity and seperates sound into diff
frequencies. This electrochemical impulse
travels through the acoustic nerve to the
temporal cortex of the brain.

7. Vertigo
 Vertigo is defined as misperception or illusion
of motion of the person or the surroundings.
 Most person with vertigo describe a spinning
sensation or say they feel as though objects
are moving around them
Signs and symptoms
 Nausea or vomiting
 Sweating and/or
 Abnormal eye movements.

9. Meniere’s disease
 Meniere’s disease is an abnormal inner ear
fluid balance caused by malabsorption in the
endolymphatic sac
 People with meniere’s disease may have
blockage in the endolymphatic duct.
Cause
Increase pressure in the system or rupture of
the inner ear membranes that producing
meniere’s symptoms.

10. Clinical manifestations
 Fluctuating
 Progressive sensorineural hearing loss
 Tinnitus
 Feeling of pressure or fullness in the ear
 Episodic
 Incapsulating vertigo with nausea and
vomiting

11. 2 subsets of Meniere’s Disease
1. Cochlear Meniere’s Disease
 Is recognized as fluctuating, progressive
sensory neural hearingloss, tinnitus and aural
pressure.
2. Vestibular Meniere’s Disease
 Occurrence of episodic vertigo associate with
aural pressure but no cochlear symptoms.

12. Normal labyrinth Dilated labyrinth

13. Diagnostic test
 Weber test- sound from a tuning fork (may
lateralize to the ear opposite the hearing loss,
the one affected with meniere’s disease)
 Audiogram – reveals a sensorineural hearing
loss in the affected ear. In the form of “Pike’s
Peak” pattern.

14. Medical management
 Low sodium diet – sodium and fluid retention disrupts the
delicate balance btw endolymph and perilymph in the
inner ear.
Pharmacologic theraphy
 Antihistamine meclizane (antivert) – supresses the
vestibular system
 Tranquilizer (diapezam) valium – used acute instances to
help control vertigo.
 Antiemetic (promethazine/phenergan) – suppositories
help control nausea and vomiting and vertigo because of
antihistamine effect.
 Diuretic theraphy (hydrochlorothiazide) – reduce
symptoms by lowering the pressure in the endolymphatic
system.

15. Surgical management
 Endolymphatic sac decompression (shunting) –
equalizes the pressure in the endolyphatic space
- A shunt or drain is inserted ion the endolymphatic
sac through a postauricular incision.
 middle ear perfusion – ototoxic medication
(streptomycin or gentamicin) can be given to pt. by
infusion into the middle and inner ear.
-this meds used to decrease vestibular function and
decrease vertigo. It requires overnight stay because
imbalance that last several weeks.
 Intraotologic catheter- to provide a conduit from the
outer ear to the inner ear. It is used to treat sudden
hearing loss and various disorder causing intractable
vertigo.
 Vestibular nerve section

17. labyrinthistis
 Inflammation of the inner ear can be bacterial or
viral in origin.
 Infection can enter the inner ear by penetrating
the membranes of the oval or round windows
(membrane).
Cause of labyrinthitis are viral diseases like:
 mumps
 Rubella
 Rubeola
 influenza

18. Clinical manifestations
 Sudden incapacitating vertigo
 Nausea and vomiting
 Various degrees of hearing loss
 Possible tinnitus
Management
 Bacterial - IV antibiotic theraphy, fluid
replacement and administration of vestibular
suppresant (meclizine and antiemetic).

20. The end!
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