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Meniere’s Disease

Last Updated: February 18, 2020

Vestibular neurotomy for Meniere’s disease: Technique

Meniere’s disease is characterized by episodic vertigo, fluctuating hearing loss for low frequencies, and tinnitus. Diagnostic criteria for the condition have been established by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) based on the initial characteristics of the disease set forth by Prosper Meniere in the 19th century.

Meniere’s is a purely clinical diagnosis, and the guidelines set by the AAO-HNS can tailor the diagnosis to range from “possible” to “certain” based on a number of criteria. Criteria for “certain” Meniere’s include two or more definite and spontaneous episodes of vertigo lasting longer than 20 minutes, fluctuating hearing loss documented by pure tone audiometry, tinnitus or fullness in the affected ear, and histopathologic confirmation of endolymphatic hydrops.

The vagaries in the criteria and the overlap of symptoms with other disorders create a challenge for the clinician attempting to establish a reliable diagnosis of Meniere’s on clinical grounds alone. Other conditions that can mimic Meniere’s disease i...