Meniere's hearing loss or something else?

[Alderica]

Hi everyone,

Two years ago, I had a severe bout of vertigo which declined gradually over 2-3 weeks, and which the doctors diagnosed as vestibular neuritis. At the time, they also gave me a hearing test and diagnosed the early stages of presbyacusis (age-related high-frequency hearing loss). I had already been prone to bouts of vertigo which would start without warning; they would go away after hours or days but I'd often be left with a kind of "brain fog" which could go on for weeks. The vertigo always seemed to come from the right side; often I would feel that I was going to fall over to the right, but I never had nausea or vomiting with it. Neither did I seem to lose my hearing, although I was and still am prone to tinnitus on that side. For a long time, the doctors said it was just stress and depression, because (until the bout of vestibular neuritis, when I had "decompensated vertigo in the horizontal semicircular canal") there were no pathological findings.

Thankfully the vertigo has become less extreme over the years (although it still affects me at times); however, over the last few months I feel as if my hearing has been getting worse. I often have to ask people to repeat themselves at least once or guess at what they are saying, and it is becoming a major nuisance.

Anyway, yesterday I saw an ENT specialist about the hearing loss. He did an audiogram of both ears, which showed the pattern typical for presbyacusis but also a low-frequency "notch" in the right ear:

Right ear:
250 Hz=15 db, 500Hz= 30 db, 1000 Hz= 20 dB, 2000 Hz=15 dB, 4000 Hz= 30 db, 8000 Hz = 50 db
Left ear:
250 Hz=10 db, 500Hz= 10db, 1000 Hz= 15 dB, 2000 Hz=15 dB, 4000 Hz= 30 db, 8000 Hz = 40 db

He also did a tympanogram, which - if I understood him correctly - revealed low pressure in the right ear.

Now he has given me betahistine (24 mg three times a day) and muttered something about cortisone infusions, but I have no clue why or what is going on? (to be honest, I was so baffled I couldn't collect my thoughts to ask more questions). Does this sound like Meniere's, or something else?

Many thanks in advance!

[Alderica]

Thank you very much for this reply! Yes, my ENT specialist suggested this maneuver too; it does help, albeit not for long. I have had this vertigo for over 20 years too, and it has declined over time, so I too wondered about advanced Meniére's...

[Dr. Kokil Mathur]

Hi!
I am sorry to hear about your medical problems. Yes, Meniere’s disease can cause hearing loss at lower frequency, however there is considerable hearing loss at lower frequencies in the initial stage. Since this is not seen in your case, you could be having an advanced stage of Meniere’s disease which can cause hearing loss with tinnitus and vertigo. Also, hearing loss at higher frequency with a notch at lower frequency and a history of tinnitus can be due to noise pollution. This pattern of hearing loss with low pressure in middle ear can also be due to ear infection and probably some fluid in the ear. Try valsalva maneuver (take a deep breath and blow while pinching your nostrils shut and closing your mouth). This will help clear the secretions in the tube that connects the back of your throat with your ear. Doing this maneuver 2-3 times after taking steam gives the best result. Repeat this maneuver at least 5-6 times a day
Please consult your doctor regarding this. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.