**5. Conclusions**

other forms of dizziness or imbalance. Physical otolaryngological exam was normal. Pure tone audiometry revealed a mild sensorineural hearing loss at the low frequencies on the right ear. Tinnitus pitch matching was centred in 250 Hz. The electrocochleography with ear canal elec‐ trode showed a high SP/AP relationship (40%) in the right ear. This may represent a typical case

**Figure 1.** Pure tone audiometry of a 32‐year‐old woman with left year tinnitus pitched at 250 Hz and no vertigo or other forms of dizziness/imbalance. Intracanal ECoG showed a high SP/AP ratio (40%) in the left ear. This may represent a

Tinnitus treatment is still a challenge. There is no FDA‐approved drug for tinnitus treatment and most of the clinical trials with drugs were not replicated, probably due to differences in the samples, tinnitus characteristics, methodology and drug dosage [31]. According to the recent consensus of the AAO‐HNS, treatment should focus on counselling, auditory stimula‐ tion and cognitive behavioural therapy [11]. On the other hand, according to many research‐ ers there is no reason that tinnitus could not be pharmacologically targeted, considering the multiple neurotransmitters and receptors involved in tinnitus pathophysiology [32]. The

of 'cochlear Ménière' in which tinnitus was the major complaint.

**4. Possible treatment implications**

cochlear form of MD with tinnitus as the sole complaint.

154 Up to Date on Meniere's Disease

Although, tinnitus is well known as a component of MD spectrum of symptoms, there is some evidence that it may occur alongside with other auditory symptoms in the absence of vertigo or other forms of dizziness. Understanding MD as a possible tinnitus subtype may unveil an important opportunity to study further tinnitus treatment strategies, such as betahistine, oxytocin and cochlear implants.
