Reflection for Meniere’s Disease in the Era of Modern Precision Medicine

Since our understanding of the mechanisms behind many diseases has improved over time, many diseases have been renamed based on their anatomical locations and pathophysiological findings. One such example is Meniere's disease (MD), a very well-known vertiginous condition named after the French physician Prosper Meniere, who had suggested in 1861 that the symptoms of the condition were caused by the inner ear instead of the brain. In contrast to its pathological findings, this symptom-based diagnosis for MD raises important questions: is MD a particular inner ear disorder or is it just an interpretation of an inner ear disorder accompanied by deafness and vertigo? There is no clear-cut criteria for MD inclusion, and diagnostic practices tend to restrict MD as a specific inner ear disease by excluding known inner ear and/or brain etiologies. In contrast to Dr. Meniere's original concept, which stressed that vertigo could be caused by inner ear problems, this exclusion criteria was not justified. The author believes that MD may have been a generic term for an inner ear disease that caused deafness and vertigo. Aside from simply issuing a diagnosis of MD, the author suggests that physicians should inform patients with deafness and vertigo about the diseased site and the associated pathological changes instead.