Which condition is characterized by episodic vertigo, fluctuating hearing loss, tinnitus, and a sense of fullness in the ear?

Which condition is characterized by episodic vertigo, fluctuating hearing loss, tinnitus, and a sense of fullness in the ear?

• A. Acoustic neuroma
• B. Otitis media
• C. Labyrinthitis
• D. Meniere disease

Answer: (D)

Meniere disease presents with episodes of vertigo plus fluctuating sensorineural hearing loss, often accompanied by tinnitus and a sense of fullness in the affected ear. The vertigo episodes arise from abnormal fluid dynamics in the inner ear (endolymphatic hydrops), which also causes hearing to wax and wane and tinnitus to fluctuate. This combination—recurrent vertigo attacks with changing hearing levels and ear fullness—is the hallmark that distinguishes it from other inner- or middle-ear conditions. Acoustic neuroma tends to cause a more gradual, unilateral hearing loss and imbalance rather than discrete vertigo episodes. Otitis media produces conductive loss with ear pain and infection signs, not fluctuating sensorineural loss. Labyrinthitis is an acute, often single-episode event with persistent vertigo and sensorineural loss during the acute phase, not the characteristic episodic pattern seen in Meniere disease.

Meniere disease presents with episodes of vertigo plus fluctuating sensorineural hearing loss, often accompanied by tinnitus and a sense of fullness in the affected ear. The vertigo episodes arise from abnormal fluid dynamics in the inner ear (endolymphatic hydrops), which also causes hearing to wax and wane and tinnitus to fluctuate. This combination—recurrent vertigo attacks with changing hearing levels and ear fullness—is the hallmark that distinguishes it from other inner- or middle-ear conditions. Acoustic neuroma tends to cause a more gradual, unilateral hearing loss and imbalance rather than discrete vertigo episodes. Otitis media produces conductive loss with ear pain and infection signs, not fluctuating sensorineural loss. Labyrinthitis is an acute, often single-episode event with persistent vertigo and sensorineural loss during the acute phase, not the characteristic episodic pattern seen in Meniere disease.