ENDOLYMPHATIC HYDROPS WITHOUT VERTIGO: Its Differential Diagnosis and Treatment

Abstract

THE CARDINAL symptom of Ménière's¹ disease is usually stated to be vertigo. The cardinal sign, however, appears to be inner ear deafness involving the low tones rather than the high, and more apparent on the bone conduction curve determined with the audiometer than on the air conduction curve. Use of the term "Ménière's disease" fixes the mind of the observer on the triad of symptoms originally described (vertigo, nausea and deafness) and has prevented attention being given to the possibility that in this condition loss of hearing might occur without development of vertigo and nausea. Since the observed pathologic change appears to have its initial expression in the scala media and the symptom of vertigo is probably produced by a fortuitous deformity of the utricle, it seems possible that Ménière's disease has as its primary expression, and possibly may have as its only clinical symptom, loss of hearing. Lindsay² has