Meniere’s Disease: Diagnostic Pearls,Therapeutic Dilemmas

Meniere’s Disease: Diagnostic Pearls,Therapeutic Dilemmas
Anthony F. Jahn MD, FACS, FRCS(C)1, Youngnan Jenny Cho, MD, FACS2
1 Director of Otology/Neurotology, Mount Sinai/Roosevelt Hospital Center, New York, NY
2 Assistant Professor of Otolaryngology/Head and Neck Surgery, Columbia University
College of Physicians and Surgeons, New York, NY

The management of Meniere’s disease is frequently frustrating. The textbook definition of this condition is excessively restrictive, and current auditory and vestibular tests are inadequate and may be misleading. It is our opinion that idiopathic endolymphatic hydrops is more common than commonly believed, and , may present in atypical ways. Further treatment opportunities may be missed unless the diagnostic criteria are broadened. We present our clinical approach to diagnosis and treatment, stressing the overriding importance of history and office evaluation, and sharing insights gained over 35 years of practice. Although diagnosis has improved, treatment dilemmas remain, and continue to challenge the otologist.