[Menière's disease. An analysis of clinical findings]

During a period of about 25 years 500 patients with Ménière's disease underwent treatment for their disease in the ENT clinic of the Charité Hospital in Berlin. In a long-term follow-up study of the course of the disease, 170 patients (80 female, 90 male) with a minimum duration of illness of 5 years could be registered. The detailed analysis based on differentiation of vertigo attacks, audiological and vestibular findings offered 3 different phases of the natural course of Méniére's disease: 1. Early phase: Vertigo attacks and fluctuating hearing loss mainly in the low-tone frequencies; 2. Chronic phase: Decrease of frequency and duration of attacks; 3. Late chronic phase: Hearing loss of nearly 50-60 dB and loss of vestibular excitability (caloric response, side difference ca. 50%). In consideration of neurological symptoms in the late chronic phase symptoms of Ménière's disease are changing into symptoms of vertebrobasilar insufficiency. The natural course of Ménière's disease and resulting therapeutical and diagnostical aspects require long-term therapeutic planning. An appropriate schedule is suggested.