How is the diagnosis of Meniere's disease primarily established?

The diagnosis of Meniere's disease is primarily established by excluding other potential conditions that may present with similar symptoms. Meniere's disease is characterized by episodes of vertigo, tinnitus, fluctuating hearing loss, and a feeling of fullness in the ear. Because these symptoms can be attributed to various other disorders, a comprehensive evaluation is necessary.

Exclusionary diagnosis involves a thorough clinical history and physical examination, alongside the consideration of other possible causes for the symptoms, such as vestibular disorders, acoustic neuroma, and other forms of hearing loss. This process helps to narrow down the diagnosis to Meniere's disease if no other conditions can satisfactorily explain the symptoms.

While auditory testing might be used to assess hearing function and confirm fluctuating hearing loss, it alone cannot diagnose Meniere's disease. Similarly, imaging studies can rule out other structural abnormalities but are not essential for confirming Meniere's itself. An ear examination can provide some information but does not definitively establish the presence of Meniere's disease. Thus, the focus on exclusion of other conditions is key to reaching an accurate diagnosis.