Ménières syndrome: a daily pattern of changes in hearing in the affected ear
Résumé
A simple test of hearing in the affected ear of a sufferer of Ménière's disease (me) has shown the following: a regular daily pattern of changes in hearing; the existence of three daily peaks of improvement in hearing; and that these peaks occurred about two hours after each of three daily meals. In one test, after skipping breakfast, the corresponding peak was absent. It is proposed that these changes in hearing were the result of raised blood insulin and sugar levels following a meal. This caused increased blood flow in the tiny blood vessels in the inner ear and improved the energy supply to vital ion-pumping epithelial cells. The context The first symptom's of what turned out to be Ménière's syndrome appeared while on a walking holiday in Cyprus, in 2002, with three severe vertigo episodes within a week. During the following months, severe vertigo was experienced at irregular intervals and the weeks between were troubled with periods of giddiness lasting days. The spells of vertigo and giddiness were accompanied by tinnitus and a sensation of 'fullness' in the right ear. The hearing loss in the right ear became evident-when using the telephone, for example. An audiogram confirmed the characteristic pattern of hearing loss, with the low tones being particularly affected. The left ear was normal. After about four years, tinnitus, which had come and gone with the periods of vertigo and giddiness, became a permanent companion, although varying in 'volume'. In 2009, observations on several occasions led to the suspicion that the hearing level in the right, affected ear changed during the day. Old scientific reflexes took over and I decided to check out what was happening. Using the rudimentary hearing test that will be described, hearing was tested during the course of a normal day. Hearing clearly changed, so the observations were continued for the rest of the week, giving the results described below. A comment on the guinea-pig: in good general health, aged 64 and 70kg, normal weight, at the time of the tests. No medication was taken during the week of observation, nor had any been taken for several months before that. However, cinnarizine (Stugeron) had been found to be helpful in dealing with dizziness and vertigo, and from such experiences it was known that one 15 mg tablet was effective within about 45 minutes. Some weeks after the time when the present observations were made, the opportunity arose to check the effect of cinnarizine on hearing and these results have been included. The method Given the limited means, it was necessary to set up a very simple hearing test. The 'laboratory' was a room with closed doors, double-glazed windows and low ambient noise in the neighbourhood. The sound source was a ticking clock. During the test, hearing by the normal left ear was blocked with a finger on the tragus. The right, malfunctioning ear was held side on to and at a level with the clock. Stopping the right ear with a finger during the test blocked out the ticking sound completely, as one would expect if only that ear was hearing the ticking during the test. The principle of the test was to find the distance from the clock at which the ticks could just be heard. Two movements were made to determine the final estimate of distance from the clock. First a position was taken where the ticks could be clearly heard and then a position further away from the clock was found where the ticks could only just be heard. To correct for any entrainment taking place, the null position was checked by stepping further away so that for a moment the ticking could
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