Which of the following is not seen in Meniere’s disease?
**Core Concept**
Meniere's disease is a disorder of the inner ear that affects balance (vestibular system) and hearing. It is characterized by episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. The pathophysiology involves endolymphatic hydrops, where there is an abnormal accumulation of fluid in the inner ear.
**Why the Correct Answer is Right**
Meniere's disease typically involves a triad of symptoms: vertigo, tinnitus, and hearing loss, particularly in the low-frequency range. The disease is often associated with endolymphatic hydrops, which can lead to damage to the hair cells in the cochlea. The correct answer is not a typical symptom or feature of Meniere's disease.
**Why Each Wrong Option is Incorrect**
**Option A:** **Vertigo** is a hallmark symptom of Meniere's disease, often accompanied by nystagmus and a sense of unsteadiness.
**Option B:** **Tinnitus** is a common symptom of Meniere's disease, often described as a low-pitched ringing or roaring sound.
**Option C:** **Hearing loss** is a characteristic feature of Meniere's disease, particularly in the low-frequency range.
**Clinical Pearl / High-Yield Fact**
Meniere's disease can be challenging to diagnose, and a thorough history, physical examination, and audiometric testing are essential for diagnosis. The presence of endolymphatic hydrops on imaging studies can support the diagnosis.
**Correct Answer:** D.