Clinical diagnosis of Ménière's disease: how useful are the American Academy of Otolaryngology Head and Neck Surgery Committee on Hearing and Equilibrium guidelines?
BACKGROUND
Ménière's disease is a diagnosis requiring expert clinical judgment. There are several differences between the American Academy of Otolaryngology Head and Neck Surgery diagnostic guidelines and Prosper Ménière's original description of the disease.


METHODS
Six hundred and fifty patients attending a specialist balance clinic had their clinical profiles fully analysed according to each set of diagnostic criteria.


RESULTS
Application of the American Academy of Otolaryngology Head and Neck Surgery guidelines resulted in the diagnosis of three times more patients than did use of Ménière's diagnostic criteria. Treatment options for patients in both groups were similar. It is unlikely that the application of different diagnostic criteria would have an effect on the treatment of individual patients.


CONCLUSIONS
The American Academy of Otolaryngology Head and Neck Surgery guidelines are more sensitive and less specific in diagnosing Ménière's disease than Prosper Ménière's original description. Standardised criteria should be applied across published series, in order to make results accurate, comparable and useful in the long term. We would recommend the introduction of a stricter diagnostic category for definite Ménière's disease.
Stapleton
E
E
Department of Otolaryngology, Otolaryngology Unit, University of Edinburgh, Edinburgh, Scotland, UK. Emmastapleton@doctors.org.uk
Mills
R
R
D003937:Diagnosis, Differential; D019983:Guideline Adherence; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008575:Meniere Disease / Q000150:complications / Q000175:diagnosis*; D017410:Practice Guidelines as Topic; D014012:Tinnitus / Q000209:etiology; D014717:Vertigo / Q000209:etiology