Among 93 patients presenting the typical symptoms of a Ménière's disease 
associating an unilateral fluctuating hearing loss of sensorineural type, 
tinnitus and vertiginous attacks lasting minutes to hours, 40 patients (43%) 
presented in their personal history a particular otologic insult in the ear 
which later on developed into the full Ménière's symptomatology, or a particular 
systemic disease with otologic manifestations. The Ménière's triad appeared in 
these patients six months to twenty nine years after the initial otologic or 
systemic lesion. Among these initial lesions were 16 cases of sudden partial or 
complete deafness related to viral or bacterial infection, 3 cases of sudden 
cochleo-vestibular deficit and 1 case of vestibular neuritis, 5 cases of 
temporal bone fractures and 4 cases of significant acoustic trauma, 2 cases of 
otosclerosis, 1 case of chronicotitis media and 1 case of severe hearing loss 
after otologic surgery, 5 cases of meningo-encephalitis and 2 cases of acquired 
syphilis. These particular lesion could be, in our opinion, the releasing factor 
of the inner ear dysfonction leading eventually to a secondary Ménière's 
syndrome.