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January 16, 2013

UFC Boss Dana White Underwent Surgery for Meniere's Disease

Balance is very important in martial arts... So imagine have a condition like Meniere's Disease and being the boss of the Ultimate Fighting Championship organization.

Dana White who is the president of the UFC organization apparently has Meniere's Disease since 2011 causing  symptoms of ringing, ear fullness, fluctuating hearing loss, and spinning attacks that last for hours to days at a time. Usually, one ear is the culprit though it can occur on both sides as well.

Presumably, he already tried conservative measures without improvement and therefore underwent surgery for this condition on January 15, 2013. [link]

What is Meniere's Disease?

It is simplistically hypothesized that Meniere's Disease, also known as endolymphatic hydrops, is due to a fluid overload within the inner ear residing inside the skull (DIFFERENT location from fluid that occurs with ear infections).

When too much fluid accumulates in the inner ear, symptoms of tinnitus, ear fullness, and hearing loss occurs followed by the spinning attack. The spinning vertigo lasts until the fluid overload dissipates.

Treatment

Treatment occurs as follows (there are variations, but these are the steps overall):

Step 1: Diet Changes

Avoid all salt, caffeine, and alcohol. Salt avoidance typically means less than 1000mg of sodium per day. Caffeine avoidance is not just coffee, but also decaffeinated coffee, coke, pepsi, tea, chocolate, etc. Alcohol avoidance is pretty self explanatory.

By avoidance of these substances, it seems to substantially minimize the amount of fluid retention that occurs in the inner preventing fluid overload and the symptoms that go with it.

If symptoms persist with dietary restrictions, than...

Step 2: Diuretic Medications

In addition to dietary avoidance of salt, caffiene, and alcohol, a prescription water pill (diuretic) is added. I typically prescribe maxzide though any diuretic will do. Diuretics force the kidneys to produce more urine to be expelled from the body. If you can believe it, the inner ear also behaves like the kidney and does the same thing preventing fluid overload within the inner ear.

If step 1 and 2 do not work, than...

Step 3: Surgery

Surgical drainage of the inner ear is called endolymphatic shunt decompression (ELS surgery). This operation is what Dana White underwent. Essentially, the mastoid bone located behind the ear is completely removed and once the inner ear structure called the endolymphatic sac is reached, it is opened and a plastic-like tubing (the shunt) is placed. Risks of surgery include permanent hearing loss and facial paralysis.

Essentially, the surgery is trying to physically drain the fluid out of the inner ear rather than medications or diet adjustments which attempts to prevent fluid from building up in the first place.

Step 4: More Surgery

There are other surgical procedures that may be tried beyond step 3, but these are considered destructive procedures and have a high risk of permanent hearing loss (consider it likely to happen) as well as the possibility of making the dizziness worse. In essence, the balance system of the ear is permanently destroyed whether thru injection of a neuro-toxic drug like gentamycin into the ear itself or surgically cutting the balance nerve completely from the brain.

Source:
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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