Disorders of the lacrimal apparatus (epiphora, dacryocystitis, etc.):

Meniere’s syndrome (endolymphatic hydrops): 

Ménière's disease is a rare disorder that affects the inner ear. It can cause vertigo, tinnitus, hearing loss, and a feeling of pressure deep inside the ear.

People with Ménière's disease usually experience some or all of these symptoms during sudden attacks, which typically last around two to three hours, although it can take a day or two for the symptoms to disappear completely.

It's worth noting, however, that the symptoms and severity of Ménière's disease vary widely from person to person. Some people may experience frequent attacks of vertigo along with hearing loss, while others may have severe tinnitus with minor vertigo. Other symptoms include sensitivity to sound (hyperacusis) or distorted sound.


The labyrinth holds the organs of balance and hearing. It’s made up of 2 parts:

  1. Bony labyrinth
  2. Membranous labyrinth

The membranous labyrinth is encased in bone and contains a fluid called endolymph. When the head moves, the endolymph also moves. This causes nerve receptors in the membranous labyrinth to signal the brain about the body's motion. Excess endolymph buildup in the labyrinth can interfere with the normal balance and hearing signals between the inner ear and the brain. This is Ménière disease.

Fluid buildup in this area may be caused by:

  • Allergies
  • Abnormal immune system response
  • Abnormal fluid drainage caused by a blockage
  • Head injury
  • Genetic risk
  • Migraine headaches
  • Viral infection

Most often, Ménière disease is caused by more than one factor.


Signs and symptoms of Meniere's disease include:

Recurring episodes of vertigo: You have a spinning sensation that starts and stops spontaneously. Episodes of vertigo occur without warning and usually last 20 minutes to several hours, but not more than 24 hours. Severe vertigo can cause nausea.

Hearing loss: Hearing loss in Meniere's disease may come and go, particularly early on. Eventually, most people have some permanent hearing loss.

Ringing in the ear (tinnitus): Tinnitus is the perception of a ringing, buzzing, roaring, whistling or hissing sound in your ear.

Feeling of fullness in the ear: People with Meniere's disease often feel pressure in an affected ear (aural fullness).

After an episode, signs and symptoms improve and might disappear entirely for a while. Over time, the frequency of episodes may lessen.


Healthcare providers will examine your ears and ask about hearing loss, tinnitus or a sense of fullness in one or both of your ears. They may ask if you have regular bouts of vertigo and hearing loss. If you do have those problems, they’ll ask if those bouts are severe and how long they last. They may do tests to rule out other potential conditions and confirm you have Ménière’s disease:

Hearing test: Audiologists use audiograms to test hearing. During this test, your provider plays sounds through headphones. You’ll press a button when you hear a sound. The results measure your ability to hear.

Vestibular test battery: Audiologists perform a series of tests to check the reflex of your inner ear (vestibular) balance system and eye muscles.

Brain magnetic resonance imaging (MRI) with contrast: This imaging test helps to rule out potential brain tumors or other issues that may cause dizziness or hearing loss.

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