Which combination of symptoms is typical of Ménière's disease?

• A. Fluctuating sensorineural hearing loss, tinnitus, ear fullness, and vertigo
• B. Chronic gradual SNHL with no vertigo
• C. Acute unilateral hearing loss with severe pain
• D. No hearing changes with vertigo

Answer: (A)

Ménière's disease is classically characterized by episodes of vertigo accompanied by changes in hearing in the same ear, with the hearing loss being fluctuating rather than permanent early on. The combination described—fluctuating sensorineural hearing loss, tinnitus, ear fullness, and vertigo—captures the hallmark pattern. The underlying idea is endolymphatic hydrops in the inner ear, which disrupts both the cochlear (hearing) and vestibular (balance) systems, leading to episodic vertigo and variable hearing loss that can wax and wane over time. Other patterns lack this distinctive mix: for example, steady, gradual hearing loss without vertigo; sudden pain-associated hearing loss; or vertigo without any hearing changes.