Operation Appears to Ease Ear Malady

For 12 years, Jean Cugle put up with sudden attacks of dizziness, the sound of a roaring waterfall and terrible pressure in her left ear. She couldn’t drive or hold a job.

The noise of the waterfall was loud enough to arouse Cugle, 48, of Ellicott City, Md. from a deep sleep.

“I would say to my sister: I know you can hear this waterfall, it is so loud,” Cugle said. “And, of course, she couldn’t. People thought I was crazy, and I felt that I was.”

Recently, desperate for relief, Cugle underwent a new surgical procedure that may end her frustrating symptoms and halt her progressive hearing loss.

“I think we have a good shot at helping her,” said Dr. Lewis Newberg, who performed the 5 1/2-hour operation.

Cugle suffers from Meniere’s disease, which has been called “glaucoma of the ear” and afflicts about one in every 3,000 people, usually between the ages of 30 and 60.

Meniere’s disease is a problem of the endolymph, or the fluid system, of the inner ear. For reasons still not clear, the volume of liquid in one ear suddenly increases, the brain gets the wrong messages and the body goes haywire.

The fluid buildup causes acute attacks that come and go, lasting minutes or hours and are often accompanied by nausea and vomiting. The buildup can cause progressive and permanent hearing loss. It usually occurs in one ear, but in about 30% of cases the second ear is affected 10 to 20 years later.

The disease can lead to a hearing loss of such magnitude that a hearing aid would be of very little help.

There is no cure. Eighty percent of the thousands of people who are plagued by Meniere’s can usually get relief by taking diuretics and antihistamines, avoiding salt and caffeine and giving up smoking. Surgery is the last resort.

For many who have had the new ear surgery, there has been a 60% increase in hearing and cessation of the debilitating symptoms, according to Dr. I. Kaufman Arenberg, a neurologist and expert in ear diseases who developed the endolymphatic duct operation. He is on the staff of Swedish Medical Center in Denver.

Precise figures about the number of endolymphatic duct operations performed in the United States and its success rate are unavailable.

Until now, the best operation for patients, Newberg said, has used a tiny shunt, a silicon tube, which is inserted in the endolymphatic sac next to the lower part of the brain, to drain a tiny amount of fluid that causes the problem. But success has been only spotty.

“The new operation may be an alternative for those who have had the sac surgery and want a better chance to hear again and get relief, possibly for the rest of their lives,” Newberg said.