Hearing Issues: Meniere's Disease or Other Causes?

Hearing-related issues

Hello Doctor, about a week ago I started feeling a slight sense of fullness in my right ear.
A few days later, I suddenly experienced a stronger tinnitus and a significant decrease in hearing, to the point where I can barely hear anything.
I went to the hospital for a hearing test, and the doctor suspected it might be caused by endolymphatic hydrops, noting a significant difference in hearing between my ears.
I was prescribed oral steroids and a medication called Sclerosol for treating Meniere's disease.
However, after five days, aside from a slight reduction in tinnitus, my hearing has not improved much.

After researching online, I found that many cases of Meniere's disease primarily present with tinnitus and vertigo, and it is rare for someone like me to experience almost complete hearing loss without dizziness.
I would like to ask if this is indeed a symptom of Meniere's disease, or could it be more indicative of an ear stroke? Is there still a chance for complete recovery in the future? It has been about ten days since the onset of symptoms, and there has been no improvement.
I also experience loud tinnitus in noisy environments.
Additionally, I am 17 years old, which is not the typical age for this condition to manifest.
Could you please explain what might have caused this illness, especially since there are no similar symptoms in my older relatives?

Niming, 10~19 year old female. Ask Date: 2023/08/24

Dr. Zheng Jueyi reply Otolaryngology

Hello, acute hearing loss is commonly associated with sudden sensorineural hearing loss or Meniere's disease.
Generally, there is a chance of hearing recovery, but a small percentage of patients do not regain their hearing completely.
If there is no significant improvement in symptoms, it is advisable to continue seeking medical treatment at a hospital.
The exact causes are often unclear, but they are commonly related to individual predispositions or viral infections.

Reply Date: 2023/08/24

More Info

Meniere's disease is a disorder of the inner ear that can lead to episodes of vertigo, tinnitus (ringing in the ears), and hearing loss. It is characterized by an abnormal buildup of fluid in the inner ear, which can disrupt the normal functioning of the auditory and vestibular systems. The symptoms you are experiencing—ear fullness, significant tinnitus, and hearing loss—are indeed consistent with Meniere's disease, although the absence of vertigo (dizziness) is somewhat atypical.
In your case, the sudden onset of severe hearing loss, particularly at a young age (17 years), raises some important considerations. While Meniere's disease typically presents with episodes of vertigo, tinnitus, and fluctuating hearing loss, it is not the only condition that can cause these symptoms. Other potential causes of sudden hearing loss include viral infections, autoimmune inner ear disease, or even a condition known as sudden sensorineural hearing loss (SSNHL), which can occur without preceding symptoms.
The treatment you are receiving, including corticosteroids, is aimed at reducing inflammation and potentially improving hearing. However, the fact that your hearing has not improved significantly after five days of treatment is concerning. It is crucial to follow up with your healthcare provider to reassess your condition. They may consider additional diagnostic tests, such as MRI or further audiometric evaluations, to rule out other causes of your symptoms, including an acoustic neuroma or other structural abnormalities.

As for the possibility of complete recovery, it varies widely among individuals. Some people with Meniere's disease experience periods of remission where symptoms improve significantly, while others may have persistent issues. The prognosis for sudden hearing loss can also vary; some individuals regain their hearing completely, while others may experience permanent loss.
Regarding the potential causes of your symptoms, Meniere's disease is often idiopathic, meaning the exact cause is unknown. However, factors such as genetics, viral infections, and even stress can play a role in its development. Since you mentioned that there is no family history of similar symptoms, it is possible that your case is unique or related to an environmental factor or a viral infection.

In conclusion, while your symptoms may align with Meniere's disease, the atypical presentation and your age warrant further investigation. It is essential to maintain open communication with your healthcare provider, adhere to the prescribed treatment, and seek additional evaluations if your symptoms do not improve. Early intervention can be crucial in managing hearing issues and improving outcomes.

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