Journal of Vestibular Research 32 (2022) 271–283 DOI:10.3233/VES-201634 IOS Press 271 Diagnosis of Meni` ere’s disease according to the criteria of 2015: Characteristics and challenges in 96 patients Friedrich Ihler a,b,1,∗ , Ivelina Stoycheva a,b,c,1 , Jennifer L. Spiegel a , Daniel Polterauer a , Joachim M ¨ uller a , Ralf Strobl b,d and Eva Grill b,d a Department of Otorhinolaryngology, LMU Klinikum, Ludwig-Maximilians-Universit¨ at M¨ unchen, Munich, Germany b German Center for Vertigo and Balance Disorders, LMU Klinikum, Ludwig-Maximilians-Universit¨ atM¨ unchen, Munich, Germany c Department of Ear, Nose, Throat, Head and Neck Surgery, Asklepios Kliniken Bad T¨ olz, Bad T ¨ olz, Germany d Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universit¨ at M¨ unchen, Munich, Germany Received 17 December 2020 Accepted 24 May 2021 Abstract. BACKGROUND: The diagnosis of Meni` ere’s disease (MD) is made according to diagnostic criteria, the last revision of which was in 2015. For diagnosis, symptoms are weighted with audiometric findings and this can be challenging in individual patients. OBJECTIVE: To analyze patient’s characteristics and symptoms in a real-life cohort of 96 patients with diagnosed MD regarding sociodemographic parameters, clinical specifics, and audiometry. METHODS: Prospective clinical patient registry containing demographic and socioeconomic parameters, symptoms, as well as pure-tone audiometry data. RESULTS: 31 patients with definite MD, and 36 with probable MD were identified. 29 patients showed typical clinical signs of MD, but did not meet the full diagnostic criteria, and were considered separately. Mean duration of symptoms prior to presentation was 3.9 ± 4.6 years. Significant differences between categories were found regarding aural fullness, tinnitus, and fluctuating hearing. If multiple audiograms were available, 28.6 % (6/21) documented fluctuating hearing. CONCLUSIONS: Current diagnostic criteria probably do not represent patients with monosymptomatic presentation or an early stage very well. Long-term follow-up with repeated audiometry is advisable. Keywords: Meni` ere’s disease, CHE diagnostic criteria, dizziness registry, international classification of vestibular disorders 1. Introduction Meni` ere’s Disease (MD) was described by Prosper Meni` ere as a characteristic triad of vertigo episodes, 1 Those authors contributed equally. ∗ Corresponding author: Friedrich Ihler, MD, Department of Otorhinolaryngology, LMU Klinikum, Marchioninistrasse 15, 81377 Munich, Germany. Tel.: +49 (0) 89 4400 73855; Fax: +49 (0) 89 4400 76869; E-mail: friedrich.ihler@med.uni-muenchen.de. fluctuating hearing loss, and tinnitus, which he as- cribed to episodic malfunction of the inner ear [3]. In clinical practice, presentation of symptoms can be very diverse and diagnosis of MD might be challeng- ing in some cases of early stage or monosymptomatic MD [27]. Beginning with the mere presentation of vertigo, patients report of spinning sensation, sway- ing vertigo, gait disorders, or dizziness with diverging length. Concerning aural symptoms, patients report ISSN 0957-4271/$35.00 © 2022 – IOS Press. All rights reserved.