[Ménière's disease].

Ménière's disease is based upon a clinical definition: the traditional Ménière's triad, a physiopathological definition, and the presence of hydrops. If all cases of Ménière's disease suffer from hydrops, not all cases of hydrops suffer from Ménière's disease. Recent progress thanks to electrocochleography, determination of the summating potential and its possible reversability under the effect of glycerol, enables a more reliable diagnostic approach, which furthermore includes the usual clinical and para-clinical examinations. Medical treatment has several objectives: the action of water on the metabolism, action on the behaviour of the labyrinthine capillaries and the biology of neurosensorial cells, action on vestibular information and the receptivity of the nerve centres and finally on the patients' lifestyle. There are two predominant surgical techniques: decompression of the endolymphatic sac and transcranial neurectomy. Two other techniques are employed in more exceptional circumstances, and only in cases of very severe deafness: transoval destruction and translabyrinthine neurectomy. The ideal clinical profile corresponding to the indications for these four surgical methods is explained.