Diagnostic criteria of Ménière's disease: Japanese, AAO-HNS, and Bárány Society's criteria

Abstract

　The diagnosis of Ménière's disease is primarily based on the clinical symptoms of vertigo attacks and hearing loss, which usually fluctuates. Historically, several different diagnostic criteria have been proposed by: 1) The Japanese Ménière's disease study group in 1974 and 2008; 2) The Japan Society for Equilibrium Research in 1987; 3) The American Academy of Otolaryngology-Head and Neck Surgery in 1995; and 4) The Bárány Society also proposed diagnostic criteria for Ménière's disease in 2015. In order to address the future direction for the diagnosis, treatment of and research into Ménière's disease, it is crucial to comprehensively understand how these criteria describe the symptoms and background etiology of Ménière's disease. For example, the exact definitions of the term “vertigo” are different among these criteria. In the Japanese criteria, “vertigo” is not restricted to a rotating sensation of the body, whereas the American criteria define vertigo of the Ménière's type as rotational vertigo. In the Japanese criteria, hearing loss temporally coincides with the vertigo attacks, whereas the American and Bárány Society's criteria do not have such restrictions. Along with the current advances in diagnostic tests for otologic diseases, Bárány Society's criteria include an updated list of the differential diagnosis for Ménière's disease. Most importantly, the Japanese criteria and the American criteria strongly support the hypothesis that the etiology of Ménière's disease is endolymphatic hydrops. In the Bárány Society's criteria, the pathogenesis includes not only the endolymphatic hydrops but other conditions as well. It is important to understand the concordance and differences of these criteria of Ménière's disease.