Secondary Meniere's Syndrome Following Excessive Noise Exposure

The effects of noise on the vestibular and balance function are under-studied. Studies have demonstrated that like the cochlea, the otolith organs are also sensitive to sound but the exact mechanism is unclear. Both impulse and continuous noise exposure may damage the cochlear and/or vestibular organ and lead to the formation of endolymphatic hydrops. We describe 9 patients who had Meniere's syndrome following excessive noise exposure.

Study design: retrospective study.Setting: Tertiary care centre in South India.Subject and methods: Medical records of patients who visited the audio vestibular clinics of a large tertiary care hospital between January 2014 and July 2021 were screened and those diagnosed with Meniere's syndrome following noise exposure were included in the study. Details of clinical presentation, investigations and management were noted.

Among 18,844 patients, 342 patients were diagnosed as Meniere's disease and endolymphatic hydrops (primary or secondary) Among these, 9 patients were diagnosed as Meniere's syndrome following excessive noise exposure (prevalence of 2.6% of Meniere's disease). Their vestibular symptoms developed after a time gap of 4 months to 9 years. Seven patients had prolonged occupational noise exposure while two had acoustic trauma. Their Pure Tone Audiogram revealed a flat or a high frequency hearing loss except in 2 patients. These patients responded well to standard treatments for Meniere's disease.

Secondary Meniere's syndrome due to excessive noise exposure constitutes about 2.6% of Meniere's disease. These could result from sudden acoustic trauma or prolonged noise exposure and seem to have a good prognosis with standard treatment of Meniere's disease and otoprotective measures. Awareness and recognition of this condition may help improve prognosis.