Brief Answer:
As below:

Detailed Answer:
Hi,

Thank you for your query.

1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus
d. Fullness in the ear
There is usually nausea and vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. Excruciating earache is not a usual symptom.

2. You should get a PTA (Pure Tone Audiogram) to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( Audiogram sloping to left).

3. Get a Tympanogram done to check middle ear pressures and Eustachian Tube function. If this Impedance Audiogram is normal, it may be Meniere's as it does not affect the middle ear. If this Impedance Audiogram is abnormal, then a trial of medication should be taken for three to four weeks. If this does not work, a myringotomy with a grommet insertion may help.

4. Meniere's disease should normally respond to a salt restricted diet, acetazolamide (diamox) and betahistine (Vertin).

5. Given your history of trauma and maxillofacial surgery in the past, the most likely condition is Trigeminal Neuralgia. Costen's Syndrome must be ruled out. Autoimmune disorder work-up must be done.

6. Sensation to the ear is supplied by many nerves, including the Trigeminal (Fifth Cranial Nerve), the Vagus (Tenth Cranial Nerve) and the Cervical plexus (C1, C2, C3). These nerves supply many other structure and areas in the head, neck, chest and even the abdomen. Hence this may be a local or referred pain from any of the regions supplied by these nerves.

7. Neuralgias may not respond to regular painkillers such as Motrin and Tylenol. Pain killers for cranial neuralgias include other types of drugs. You may request your physician for a trial with amitriptyline, carbamazepine, gabapentin or pregabalin. All these can cause severe drowsiness.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.

---