Hearing Loss in Meniere’s Disease – Help is Available
The good news is that a hearing aid can help with hearing loss in Meniere’s disease.
- Meniere’s disease is a combination of symptoms caused by an excess of fluid in the inner ear. The manifestation of the disease may vary but eventually, someone with hearing loss in Meniere’s disease will experience all the following symptoms:
- Blocked ear
- Tinnitus (ringing or roaring in the ears)
- Fluctuating Hearing loss
- Vertigo (dizzy spells)
Everyone who suffers from Meniere’s has some degree of hearing loss but this is often overlooked as priority is given to control vertigo which is the most disturbing of the 4 symptoms.
How Does Meniere’s Affect Hearing?
Meniere’s disease most often occurs in only one ear, so most people have a unilateral hearing loss with normal hearing on the other ear. These individuals find it difficult to hear when significant background noise is present. They also perceive loud noises as unusually loud, sometimes even painful. This phenomenon, known as recruitment, results from damaged hair cells in the cochlea.
Wearing an earplug in the affected ear won’t help at all; in fact, it aggravates the problem by making the ear more sensitive to sounds.
The hearing loss also affects the ability to locate where sounds are coming from. The brain localises sound by analysing differences between the signals coming from both ears, so when acoustic input mostly comes from the better hearing ear, the sound localisation is thrown off.
Bilateral Meniere’s disease
It is less common for Meniere’s to affect both ears, but when this happens the hearing levels are always different in each ear. Individuals with Meniere’s disease in both ears have a bilateral asymmetrical hearing loss.
The ears work together by sending acoustic signals to be processed at the brain. When there is an asymmetry in the hearing between the two ears, the brain gets confused with the mismatched signals.
Hearing Loss and Balance Function
Balance function becomes gradually impaired as the disease progresses. After several bouts of spinning attacks, the balance organ becomes permanently damaged affecting the individual’s overall ability to maintain optimal balance.
Hearing loss in Meniere’s disease reduces awareness of the immediate surroundings thus further aggravating balance disturbance which is already present.
Managing Meniere’s With Hearing Aids
There is still no effective cure for Meniere’s disease as the cause is still unknown. The best approach to treat the disease is by managing the symptoms. Audiologists have found hearing rehabilitation is an effective form of symptom management, so they advocate hearing aids for hearing loss in Meniere’s Disease.
In most cases, the hearing aids not only significantly improve hearing ability but also reduce or even eliminate tinnitus as well as help to improve overall balance function.
How do Hearing Aids Work?
Hearing aids are not meant to make sounds louder but rather clearer. Hearing aids digitally equalise loudness of incoming sound to compensate for the hearing loss. They amplify soft sounds, bringing them up to an audible level and compress loud sounds to a comfortable level.
Limitations of Conventional Hearing Aids for Meniere’s Disease
Hearing loss fluctuates in Meniere’s disease. Fluctuation means that hearing can suddenly become better but drop down again later. Changes in hearing levels are unpredictable. It may occur as often as several times in one day during the active stages of the disease and then become stable again for weeks or months. Such fluctuation makes it difficult to set a hearing aid to the correct level. For this reason, many give up on their hearing aids as they only provide benefit some of the time. A hearing aid with multiple programs provide little help as the pattern of hearing fluctuation is also unpredictable. A volume control is only useful when the hearing fluctuation is linear as in the later stages of Meniere’s disease.
Self-Programmable Hearing Aids help hearing loss in Meniere’s disease
In 2005, Dr Celene McNeill described a protocol to address hearing fluctuation by providing instrumentation to the patients to adjust their own hearing aids at home as hearing fluctuates. Celene’s protocol uses special hearing aids which allow the user to test their own hearing and to set the amplification to optimum levels as the hearing fluctuates. Technological advances have made it even easier to implement such protocol which empowers the user to control their own hearing fluctuation without the need to go back to the audiologist as frequently.
- McNeill C, Taylor A. Tinnitus perception and the effects of a self-programmable hearing aid on hearing fluctuation due to Meniere’s disease. January 2010. The New Zealand Medical Journal. Volume 123 (1311): pages 126-135. http://www.whirledfoundation.org/wp-content/uploads/2015/09/1009_Hearing-Loss-in-Menieres.pdf
- McNeill Celene “A hearing aid system for fluctuating hearing loss due to Meniere’s disease: a case study”. (2005) ANZJA, 27, 78-84.
- McNeill Celene, McMahon C, Newall Philip, Kalantzis MaryHearing aids for Meniere’s Syndrome – implications of hearing fluctuation. J Am Acad Audiol. (2008) 19:430-434