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H81.0 Meniere Disease: Causes, Symptoms & Treatment
H81.0 is the ICD-10 code for Meniere disease, an inner ear condition causing episodes of vertigo, hearing loss, tinnitus, and ear fullness.
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H81.0 is the ICD-10 code for Meniere disease, an inner ear condition causing episodes of vertigo, hearing loss, tinnitus, and ear fullness.
What is H81.0 (Meniere Disease)?
H81.0 is the ICD-10 diagnostic code for Meniere disease (also written as Ménière disease or Morbus Ménière). It is a chronic disorder of the inner ear characterized by recurring episodes of intense rotational vertigo, fluctuating hearing loss, tinnitus (ringing in the ear), and a feeling of fullness or pressure in the affected ear. The condition was first described by the French physician Prosper Ménière in the 19th century.
Causes
The exact cause of Meniere disease is not yet fully understood. The main underlying mechanism is thought to be an abnormal accumulation of fluid in the inner ear, known as endolymphatic hydrops, which increases pressure within the endolymphatic system. Contributing factors may include:
- Autoimmune reactions
- Viral infections (e.g., herpes viruses)
- Genetic predisposition
- Circulatory disturbances in the inner ear
- Allergies
- Stress and psychosomatic influences
Symptoms
Meniere disease typically presents in episodic attacks lasting from minutes to several hours. Key symptoms include:
- Sudden severe vertigo accompanied by nausea and vomiting
- Unilateral tinnitus (often described as roaring, buzzing, or ringing)
- Fluctuating hearing loss, initially affecting low-frequency sounds
- Feeling of pressure or fullness in the affected ear
- In advanced stages: permanent hearing loss
Diagnosis
Diagnosis is primarily clinical, based on the characteristic combination of symptoms. The following tests are commonly used:
- Audiometry (hearing test) to detect the typical low-frequency hearing loss pattern
- Vestibular function tests (e.g., caloric testing) to assess the balance system
- Electrocochleography (ECochG) to measure endolymphatic pressure
- MRI of the inner ear to exclude other causes such as vestibular schwannoma
- Differential diagnosis to rule out other vestibular disorders
Treatment
General Measures
During an acute attack, symptomatic medications are used to relieve vertigo and nausea. Long-term management involves several approaches:
Pharmacological Treatment
- Betahistine (H1 agonist / H3 antagonist) to improve inner ear blood flow and reduce attack frequency
- Diuretics to reduce endolymphatic fluid pressure
- Antiemetics and antivertigo drugs (e.g., dimenhydrinate) for acute episodes
- Corticosteroids in cases with inflammatory involvement
Interventional and Surgical Treatment
- Intratympanic corticosteroid injection: corticosteroid delivered through the eardrum
- Intratympanic gentamicin therapy: chemical ablation of the affected vestibular organ
- Endolymphatic sac surgery: decompression to relieve fluid pressure
- In severe cases: vestibular nerve section (cutting the balance nerve)
Lifestyle and Prevention
- Low-sodium diet to support fluid balance
- Stress reduction and psychological support
- Avoiding caffeine, alcohol, and nicotine
- Regular follow-up with an ENT specialist
Prognosis
The course of Meniere disease varies significantly between individuals. In many patients, the frequency and severity of vertigo attacks decrease over time, while hearing loss may progressively worsen. A complete cure is currently not available, but consistent treatment can significantly improve quality of life.
References
- German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC): S2k Clinical Guideline Meniere Disease, AWMF Register No. 017-010 (2021).
- Bhattacharyya N, et al. - Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo and Related Vestibular Disorders. Otolaryngology - Head and Neck Surgery (2017).
- World Health Organization (WHO): ICD-10 Version 2019, H81.0 Meniere Disease. Available at: https://icd.who.int/
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