1. What is Ménière’s disease? What causes it? First of all, let’s understand the ear. The ear is divided into the outer ear, middle ear and inner ear from outside to inside. In Meniere’s disease, the onset of the disease is located in the deepest part of the membranous vagus of the ear, and is caused by excess lymphatic fluid in the membranous vagus, i.e., fluid accumulation in the membranous vagus. What causes fluid accumulation in the membranous vagus? Unfortunately, after many years of research at home and abroad, the exact cause of the disease has not yet been fully understood (in fact, the vast majority of diseases are of unknown etiology, which is where the mystery of the human body lies), and may be related to a variety of factors such as diet, immunity, inflammation, and genetics. 2. What are the manifestations of Ménière’s disease? The typical manifestations of Ménière’s disease are vertigo, tinnitus, ear congestion and hearing loss. The vertigo is mostly spinning and overturning, mostly accompanied by nausea, vomiting, cold sweat, pale face, etc. Most of them are bedridden, and the vertigo lasts from 20 minutes to several hours. It is relieved after rest or with medication. No matter how dizzy the patient is, he or she is always alert and does not lose consciousness. Tinnitus may be the earliest manifestation of the disease. In the early stage, it is mostly intermittent low-pitched humming-like tinnitus, and as the disease progresses, the tinnitus gradually becomes a persistent high-pitched cicada sound, or a mixture of multiple sounds. Ear stuffiness is intermittent in the early stages of the disease, and is a sensation of stuffing cotton in the ear or water in the ear. As the disease progresses, the stuffiness may become persistent. Hearing loss in the early stages of the disease is mostly low-frequency hearing loss, which is often not felt by patients and can only be detected by hearing tests. In the early stages of the disease, as the vertigo subsides, hearing can return to its pre-onset level. However, as the disease progresses, hearing loss will gradually worsen until total deafness. 3.How to prevent Ménière’s disease? For all diseases, a regular and healthy lifestyle is essential. For people with Ménière’s disease, it is also important to pay attention to the following points: First, it is important to reduce salt intake (the amount that goes into your mouth), preferably to a total of less than 2 grams per day. Many foods such as salted vegetables, soy sauce, and cured meats are high in salt and are best avoided. This is a special reminder that eating less salt is not the same as having a light taste. Some patients have added vinegar to their rice to dilute the saltiness, which is completely wrong. Secondly, avoid eating coffee, chocolate, strong tea, tea drinks, cola, wine, etc., because these foods may induce disease attacks. Once again, keep your mood upbeat and don’t stay up late. Depression and staying up late will aggravate tinnitus, and tinnitus will make people more irritable, which are all harmful but not beneficial to the recovery of the disease. 4.How to treat Ménière’s disease? The standard treatment for Ménière’s disease is called “stepwise treatment”, which means that different treatment protocols are used for patients at different stages of the disease. The first step: lifestyle changes (see 3. How to prevent Ménière’s disease?) The first step is to make lifestyle changes (see 3. What can be done to prevent Ménière’s disease? Good habits will slow down the progression of the disease and slow down the frequency of attacks. The second step: medication, applicable when hearing is relatively good in the early stages of the disease. You can apply diuretics (to reduce fluid accumulation in the inner ear) + potassium agents (to replenish potassium ions lost with urine and maintain electrolyte balance in the body) + improve microcirculation + nutritive nerve drugs + tympanic chamber perfusion hormone + Min Make Long (to promote vestibular recovery). What medication to use and for how long needs to be determined by the doctor according to the patient’s condition, not all patients are given the same medication, and patients should not buy and use the medication at home according to the previous formula. Your condition is changing, and your laziness will only harm you. A special reminder is that medications such as vertigo ninhydrin, dizzying painkillers, and powerful vertigo tablets should only be used for acute attacks of vertigo and should not be taken for long periods of time. These medications are vestibular depressants and can interfere with the recovery of vestibular function! Step 3: Meniett positive pressure ventilation therapy is used for those who are not well controlled by medication. This treatment requires a tympanotomy, where a small hole is cut in the tympanic membrane and a middle ear ventilation tube is placed before the device can be applied to put pressure in the ear. Because of the risk of otitis media infection due to the tympanotomy, and because water cannot be introduced into the ear at all times, clinical use is limited. Step 4: Endolymphatic sac decompression surgery is used for those who are poorly controlled by the above methods. It needs to be operated under general anesthesia, and there is a risk of cerebrospinal fluid leakage and intracranial infection, but it does not damage the patient’s residual hearing and usually does not increase tinnitus. A few patients will have recurrence of vertigo after surgery and need further treatment. Step 5: Chemical vagotomy, for those who are poorly treated by the above four methods. This method treats Ménière’s disease by disrupting vestibular function with an injection of the ototoxic drug gentamicin into the ear. Patients usually experience an increase in vertigo for a short period of time after the injection of the drug, which requires a series of vestibular rehabilitation treatments for slow relief. This method is more economical and convenient, but carries the risk of increased deafness, increased tinnitus, and recurrence of vertigo. Step 6: Semicircular canal obstruction surgery, used for those who have poor results with the previous methods. It requires surgery under general anesthesia and is used preferentially in patients with poor hearing. This procedure is effective in Meniere’s disease, but carries the risk of increased deafness and increased tinnitus. Immediately after surgery, patients experience a significant increase in vertigo, but this is gradually relieved with vestibular rehabilitation. Step 7: Vestibular nerve dissection and vagotomy: for those who have failed all the above methods. At present, very few patients need to perform the seventh step because of the exact efficacy of the surgery for semicircular canal obstruction. 5.Can Ménière’s disease be cured? Is it fatal? If you read the above, you will know that Ménière’s disease is not fatal, but it is very annoying, recurrent and gradually aggravated. At present, the treatment of the disease is mostly carried out according to the above stepwise treatment method. As long as the disease is properly understood and actively treated with doctors, the disease can be better controlled in most cases. In some cases, the symptoms will be relieved on their own when the patient enters old age. 6. Can we treat only tinnitus? No, because tinnitus, stuffy ears, deafness and vertigo are all different symptoms of one disease. 7.What happens if I don’t treat it? The consequence of not treating Meniere’s disease is that within two or three years, total deafness may occur on the affected side, and total deafness on one side may be followed by deafness on the opposite ear. In a small number of cases, both ears develop Ménière’s disease at the same time. If left untreated, both ears will become deaf and the quality of life will be seriously affected. 8. Do I have to go to the hospital for a review? It is very important to go to the hospital for regular checkups. Since Ménière’s disease can recur and progress, doctors need to know the patient’s reaction to medication, any fluctuations in hearing, any damage to liver and kidney function after long-term use of medication, and the patient’s mental state in order to adjust the treatment plan in time to achieve the best treatment effect.