Hydropic Ear Disease: Clinical features and Classification

Introduction:

Since 1972, Menière's Diseaes (MD) is being defined as the idiopathic syndrome of endolymphatic hydrops (ELH). In 2015, a worldwide controversy has been triggered by the a classification proposal which contradicted the traditional concept of MD.

Methods:

Analysis of the historical development of the concept „Menière's disease” by the classification proposals 1972 – 2019. Description of the clinical features of patients with Hydropic Ear Disease. Demonstration and critical discussion of the differences among the classification proposals. Illustration of possible consequences for practice and research, which could result from the use of these proposals.

Results:

ELH of the inner ear has numerous pathophysiological consequences. Its very tight association with the typical audiovestibular symptoms founds the disease concept of Hydropic Ear Disease as a comprehensive concept which includes both the pathology and its symptoms. The diagnostic criteria proposed in 2015 are audiologically faulty and less precise and circumscript than the traditional critiera (AAO-HNS 1995).

Conclusion:

The diagnostic criteria proposed in 2015 do not bring a significant improvement, neither for clinical practice nor for research. They should therefore not be adopted by the German-speaking ENT societies. In the future, classifications which consider radiological diagnosis of ELH (e.g. the classification of Hydropic Ear Disease) will likely play an important role. Until thin, it is recommended to continue to use the well-approved criteria of the AAO-HNS 1995.

Publication History

Publication Date:
23 April 2019 (online)