Resources
Glossary
The working vocabulary of Ménière’s disease. Inline dotted terms throughout the chapter link here.
- Aural fullness
- A sensation of pressure or blockage in the affected ear, often a premonitory warning of an attack.
- Betahistine
- A histamine analogue widely prescribed for Ménière's; the randomised BEMED trial found it no better than placebo for attack frequency, though it remains in common use.
- Electrocochleography (ECochG)
- A test recording cochlear potentials; an elevated summating-potential to action-potential (SP/AP) ratio supports hydrops, though sensitivity is limited.
- Endolymph
- The potassium-rich fluid of the membranous labyrinth (scala media). Its volume is regulated largely by the endolymphatic sac and duct.
- Endolymphatic hydrops
- Distension of the endolymph-filled scala media from an imbalance of endolymph production and resorption. The pathological hallmark of Ménière's — though it is now seen as a marker rather than the direct cause of every symptom.
- Endolymphatic sac
- The blind-ended structure that resorbs endolymph and regulates its volume; a target of decompression surgery.
- Intratympanic gentamicin
- A vestibulotoxic aminoglycoside instilled into the middle ear to chemically ablate vestibular function in the affected ear, controlling vertigo at the risk of further hearing loss.
- Intratympanic therapy
- Delivery of a drug across the tympanic membrane into the middle ear for diffusion to the inner ear — used for gentamicin (ablative) or steroids (gland-sparing).
- Lermoyez syndrome
- An unusual variant in which hearing and tinnitus improve as the vertigo begins — the reverse of the usual sequence.
- Low-frequency hearing loss
- Loss greatest at 250–1000 Hz — the early audiometric signature of Ménière's, giving a rising audiogram that recovers between attacks.
- Ménière's disease
- An inner-ear disorder of recurrent spontaneous vertigo (20 min – 12 h) with fluctuating low-frequency sensorineural hearing loss, tinnitus and aural fullness, associated with endolymphatic hydrops.
- Perilymph
- The sodium-rich fluid of the bony labyrinth (scala vestibuli and tympani), surrounding the membranous labyrinth.
- Reissner's membrane
- The thin membrane separating endolymph (scala media) from perilymph (scala vestibuli). It bulges with hydrops and may rupture, mixing the fluids — one proposed mechanism of an attack.
- Sensorineural hearing loss (SNHL)
- Hearing loss from the cochlea or auditory nerve. In Ménière's it characteristically begins in the low frequencies and fluctuates.
- Tinnitus
- Perceived sound without an external source; in Ménière's often a low-pitched roar that intensifies before an attack.
- Tumarkin otolithic crisis · drop attack
- A sudden fall to the ground without warning or loss of consciousness, from an abrupt otolithic discharge. A late-stage feature and an indication to escalate treatment.
- Vestibular ablation
- Deliberate destruction of vestibular function (chemically with gentamicin, or surgically) to abolish the abnormal signals driving vertigo; reserved for intractable disease.