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At last, there's an end to the torment of Ménière's

Posted Aug 12 2009 10:52pm

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Taken from Mail Online
A constant ringing in her ears was the first sign that something was wrong. A few weeks later Benie Jewels also started experiencing dizzy spells. 'It felt as if I was spinning, but mostly as if I was on a boat in really stormy waters for ten minutes,' recalls the 29-year-old marketing manager from London.

'I felt completely disorientated and nauseous. Most of the time I could manage, but if an attack occurred I had to stop what I was doing and sit down.'

Over the weeks the tinnitus (the ringing in the ears) got louder. 'I had no idea what was wrong - I felt fine otherwise - it was horrible and really disconcerting,' she says.

Benie's GP referred her to a specialist before scans and a hearing test confirmed the diagnosis: Ménière's disease.
Around 40,000 people suffer from Ménière's, and many end up with permanent hearing loss.

The condition can also lead to depression and anxiety. But Benie was one of the lucky ones - she's benefited from a new treatment for the disease.

Experts have hailed it as one of the biggest breakthroughs in treating the condition for many years.

Ménière's disease is a condition that affects a part of the inner ear known as the labyrinth. This is comprised of tiny fluid-filled channels that help transmit sound vibrations to the brain. The labyrinth is also key to our sense of balance, sensing when the head moves and transmitting this information, via the vestibular nerve, to the brain.

With Ménière's, the fluid in the labyrinth builds up, causing the tissue to swell, and disrupting both hearing and balance. This leads to symptoms such as vertigo (attacks may last anything from several minutes to 24 hours), nausea, vomiting, palpitations and sweating.

'It is a progressive condition that usually starts in one ear; in half of cases, it progresses to the other ear,' says Sarah Lucas of the Ménière's Society. 'It can take months, or even years, to diagnose this awful condition.'
'One of the reasons is that other conditions cause similar problems and doctors can't see into the inner ear to determine whether it is Ménière's or not.

'It can be a very scary condition to have, especially if you get vertigo, and particularly if you don't know what's causing it. Some people are too frightened to go outside in case they get an attack.'

It is not known what exactly causes the build-up of fluid, although bone abnormalities in the middle ear and infections may play a part.

There is also no established cure. Some doctors believe that reducing the amount of salt in the diet as well as avoiding caffeine and alcohol can help, although the evidence is only anecdotal.

Patients may also be prescribed drugs to tackle the amount of fluid produced in the labyrinth. Sometimes patients are offered an injection into the middle ear with a drug called gentamicin. This destroys cells within the fluid, reducing the amount of fluid. However, this treatment can actually exacerbate balance and hearing problems.
As a last resort, patients may be offered surgery, removing some of the bone in the inner ear to create more space.

'The traditional treatment options won't cure it,' says Sarah Lucas. 'Treatment is aimed at reducing, controlling and helping the symptoms.'

Initially, Benie was prescribed drugs. However, the tinnitus got even louder, until last July - six months after the problem started - she suffered a vertigo attack that lasted for five hours.

Answer to the problem: Around 40,000 people suffer from Ménière's, and many end up with permanent hearing loss. But now a new treatment which involves injecting steroids into the ear is being trialled at London's Imperial College.

Her consultant then told her about a new procedure being tested in a clinical study at the College's Healthcare NHS Trust.

Doctors there are injecting steroids straight into the ear to calm the inflammation and reduce the swelling in the labyrinth. The trial will compare whether the steroid treatment is as effective as the traditional gentamicin injections, but without the side-effects.

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'Although the new treatment with steroids sounded really painful, I knew I had no option,' says Benie. 'I knew I couldn't go on like I was for much longer, and that I could end up deaf.'

Michael Wareing, the head of the ENT department at St Bartholomew's NHS hospital and a consultant at The London Clinic, explains: 'The needle goes about an inch into the ear.

'Earlier studies indicate it may work on up to 70 per cent of patients with Ménière's and that it could be more suitable for some sufferers as it's gentler on the delicate ear than gentamicin.'

Some people will need only one jab; others may need up to five or more. Patients are assessed a month afterwards to see the results - there are no known side-effects.

The scientists heading up the trial are hopeful that it could help thousands. 'These steroid jabs are the hottest trial for Ménière's disease,' says Professor Adolfo Bronstein, head of neurotology at Imperial College Healthcare NHS Trust and principle investigator of the trial.

'We hope that in the long run it will be able to provide these patients with a much better quality of life.'
Benie had the treatment last October. 'It was painful, even with the local anaesthetic,' she says. 'I couldn't move either, as the needle was inside my left ear, so it was pretty unbearable.'

The entire procedure lasted for ten minutes. She then had to lie on her right side for 30 minutes for the steroids to act.

'A few days afterwards, I noticed the ringing had disappeared,' she says. 'It's not come back since, and neither has the vertigo. I'm elated that I've been able to lead a normal life again. As far as I know, I'm cured.'

Read more at the Daily Mail Online.

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