Meniere's disease is a disorder of the inner ear

Purpose of reviewMeniere's disease is a disorder characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and pressure in the ear. Its pathogenesis and optimal management continue to be the subject of ongoing debate. Although it is classically believed to be a primary disorder of the inner ear, some clinicians have hypothesized that it is a form of vestibular migraine.Recent findingsEvidence supporting vestibular migraine in the differential of Meniere's disease includes overlap of symptoms, high prevalence of migraines in patients with Meniere's disease, and the efficacy of migraine treatments for symptoms of Meniere's disease in some patients. However, there is far more evidence to support Meniere's disease as a disorder of the inner ear, including genetic and histologic changes of hydrops, imaging studies showing hydropic changes, predominance of low-frequency hearing loss, clinical efficacy of treatments targeted at inflammatory change/hydrops, and clinical efficacy of ablating the vestibular end-organ.SummaryAlthough there is conflicting evidence regarding the cause and treatment of Meniere's disease, current evidence favors it as a disorder of the inner ear. Further research is needed to fully understand the mechanisms of Meniere's disease and how to improve diagnosis and treatment outcomes.