Classification of Menière's disease.

To create a rational treatment system for Meniere's disease, it is helpful to divide Meniere's disease into five stages according to the signs, symptoms, pathology, and natural history by recalling what is known for certain and what is probably true about Meniere's disease. It is known that Meniere's disease is attributable to endolymphatic hydrops, caused by a small, malfunctioning endolymphatic sac, abnormally placed since birth, and Meniere's disease is therefore a congenital disorder of the endolymphatic sac. It is probably true that there is often an immune, viral, metabolic, or other insult to the inner ear, that disturbs the balance between the cochlea, where endolymph is produced, and the endolymphatic sac, where most of it is absorbed. Using this five-stage classification, it is possible to separate Meniere's disease into the first three stages, for which different but reasonable treatments are possible, and the last two stages, for which no treatments are effective.