Meniere disease is one of the most fascinating and most vexing of all clinical conditions encountered by the otolaryngologist. Operationally speaking, a Meniere ear is a fragile ear. In fact, Meniere disease can and should be redefined as a degenerating inner ear that has impairment of one or more homeostatic systems, resulting in instability of hearing and balance function. This updated definition is a valuable guide to the clinical epidemiology and presentation of Meniere disease and to understanding the effects of conservative treatments. In the absence of a definitive test for Meniere disease, the greatest challenge for the clinician may be differentiating this condition from migraine. Ultimately, Meniere vertigo attacks are controllable in more than 99% of cases, but hearing loss and other auditory symptoms tend to be unresponsive to treatment.
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