Introduction

In 1861 Prosper Ménière described a syndrome characterised by deafness, tinnitus, and episodic vertigo. Contrary to the thinking at that time, he correctly thought that the condition was a disorder of the inner ear.1 In 1938 the principal underlying pathology, endolymphatic hydrops, was described by Hallpike and Cairns (fig 1),2 but the precise aetiology of Ménière's disease still remains elusive. This fact, coupled with the capricious behaviour of the disease and the clinically important response to placebo treatment, has aroused controversy about its management and has plagued the scientific evaluation of the results of the various treatments used.

Methods

Over the years, a vast literature has accumulated on Ménière's disease. I have based this article on information gained from three sources.

The first was a Medline search from 1966 to 1997, which yielded nearly 2000 references using the text word “Ménière's” and 546 citations …