A Case of Bilateral Meniere's Disease with Alternatively See-saw Fluctuations of Bilateral Hearing Impairments

In most patients with bilateral Meniere's disease, there is a lapse of 10 years between the involvement of the first and the second ear (Greven & Oosterveld 1975). However, we encountered a 47 years old man with bilateral Meniere's disease, in whom the interval between the onset of the impairment in first the right ear and then left ear occurred after 24 years.One of the most characteristic features in this patient was the alternatively see-saw fluctuation of the bilateral hearing impairment after the second involvement. In this characteristic fluctuation of hearing impairment, the unilateral hearingloss improves while the contralateral worsens at the same episode, resembling the action of see-saw. These fluctuations in hearing impairment were observed during the glycerol test, and after endolymphatic sac surgery. Therefore, we assumed that the alternative fluctuation of bilateral hearing impairments could be one of the events of bilateral Meniere's disease, caused by passing osmolarity disorders in the right and the left ear, alternatively.