Clinical findings in Menière's disease with bilateral fluctuant hearing loss.

Our department conducted an examination of the clinical characteristics of Menière's disease with bilateral fluctuant hearing loss, using data obtained in a survey involving sixteen institutes associated with the Vestibular Disorder Research Committee, Japan. A total of 480 cases were surveyed, of which 204 showed normal hearing in the second ear, and were thus classified as unilateral Menière's disease, or Menière's disease with unilateral involvement; 135 cases showed fluctuating cochlear symptoms in the second ear, and were therefore classified as Menière's disease with bilateral fluctuant hearing loss or bilateral involvement. Our results show that patients with bilateral involvement experience increased disruption of daily life activities, and respond poorly to therapy with diuretics or steroids. Hospitalization is often considered for these patients. For these reasons it is especially important that bilaterality be diagnosed as early as possible, and that intensive treatment be carried out. ENT specialists must recognize the seriousness of bilateral involvement, and take particular precautions against its occurrence.