[Monosymptomatic onset of Menière's disease]

The occurrence of monosymptomatic courses of Menière's disease is not generally accepted, although cochlear forms are described in literature. Retrospectively, we evaluated the case histories of 108 patients with Menière disease, who developed the typical trias in the further course of the disease. Among these 108 patients, we found 39 with a true monosymptomatic course, i.e., in each case we could exclude the participation of either the cochlea, or the labyrinth by exact clinical investigations. Two-thirds of the patients first noticed the impairment of hearing, one-third the vertigo. Basing on a time interval of more than one year, there were still 18 patients with a monosymptomatic course. The average duration of the monosymptomatic courses is distinctly shorter than the duration of the typical trias and, consequently, we defined them as equivalents to early forms of the disease. At this early stage a diagnosis is possible by the fluctuating cochlear signs with their typical audiogram configurations, and the attack character of the vestibular symptoms.