Hi,
Thank you for your query.
1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c.
Tinnitus (abnormal sounds in the ear)
d. Fullness in the ear
There is usually nausea (feeling sick) or vomiting, the hearing usually worsens during an attack and the tinnitus also worsens.
2. You should get a PTA (Pure Tone Audiogram) done to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( an 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 Disease as it does not affect the middle ear. He may have had these tests done before the
Myringotomy and grommet insertion.
4. Meniere's disease should normally respond to a salt restricted diet,
acetazolamide (Diamox) and
betahistine (Vertin).
5. If fluid or negative pressure detected again in the middle ear by a Tympanogram ('B' or 'C' type graph), the initial treatment will include anti-allergic, decongestant medication and steam inhalation.
6. The fuzzy / disoriented feeling is common in
dizziness. Unsteadiness must be differentiated from true spinning vertigo. Positional Vertigo must be ruled out by direct examination. Is there any
nystagmus (abnormal movements of the eyes) noted by your doctor? Is there any headache or are there any visual disturbances?
7. Get a CT PNS (Para Nasal Sinus) Scan done. If there are too may artifacts due to the metal rods, get X-rays done. Upload them here at bit.ly/Dr-Sumit-Bhatti
8. He may also be suffering the side effects of Panadeine, including dizziness and
constipation.
Regards.