2017 Volume 76 Issue 4 Pages 302-309
In this symposium, we have discussed the diagnostic criteria of Ménière's disease including the newly published one from the Japan Society for Equilibrium Research (JSER) in 2016.
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 published by: 1) The Japanese Ménière's disease study group in 1974 and 2008; 2) The JSER in 1987 and 2016; and 3) The American Academy of Otolaryngology-Head and Neck Surgery in 1995. 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 and research of 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” differ among these criteria. In the Japanese criteria, “vertigo” is not restricted to a rotating sensation of the body, whereas the American criteria define “vertigo” as a spinning sensation. 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, the 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, and the Japan Society's 2016 criteria include MRI identification of hydrops. In the Bárány Society's criteria, the pathogenesis includes not only endolymphatic hydrops but other conditions as well. It is important to understand the concordance and differences of these criteria for the diagnosis of Ménière's disease.
