Origin of Ménière’s disease

  In 1948, Prosper Meniere, a French physician, made many annotations while translating a German textbook into French, and one of them was that a girl who had been sightseeing on the roof of a carriage and had gradually felt dizzy and had lost her hearing on the way had consulted him upon arrival in Paris, but unexpectedly died a few days later. An autopsy revealed a red, sticky lymphatic fluid in the patient’s ear. Thirteen years later, in 1861, Menière delivered a landmark lecture at the annual French medical meeting, detailing the cases of vertigo, hearing loss, and tinnitus that had accumulated over thirteen years as a new clinical disorder that could be related to inner ear hemorrhage. In Menière’s time, the main cause of vertigo, deafness and tinnitus was attributed to hemorrhage in the vagus, and the disease was first named by the Hungarian physician Boritz in 1867 under the Menière surname, and the term Menière’s disease is still used today. Most practicing physicians of that era began to name vertigo diseases after Ménière, whereas now it seems clearly inappropriate to attribute all vertigo diseases to Ménière’s disease.  As time progressed and medicine evolved, the results of the 1938 study by Heilpick and Kearns laid the foundation for what is now known as Ménière’s disease. They observed the temporal bone specimens of two patients who died of Ménière’s disease due to VIII neurectomy and found that the main pathological findings of their Ménière’s disease were endolymphatic hydrops, i.e., marked dilatation of the entire membranous vagus, displacement of the vestibular membrane, partial herniation into the vestibular step, the cochlear foramen or even the top of the tympanic step; thinning and swelling of the walls of the balloon and ellipsoid bursae. Since then, Ménière’s disease has been considered synonymous with hydrocele of the membranous vagus.  Since the latter part of the last century, more and more studies have proven that many causes can cause the pathological process of membranous vagal effusion and symptoms similar to those of Ménière’s disease, such as trauma, bacterial or viral infections, metabolic diseases, drug intoxication, congenital dysplasia, vascular causes, etc., and then divided the membranous vagal effusion into primary and secondary, while Ménière’s disease was defined as primary membranous vagal effusion. In 1981, Professor Thuenet of Harvard Medical School summarized many research results and literature and classified membranous vagus effusion into primary and secondary, and then each has congenital and acquired, the latter has existent symptomatic and insidious, for a total of eight types, while Meniere’s disease is defined as primary, acquired, symptomatic membranous vagal effusion. To date, it can be considered as an unexplained, non-developmental disorder of the inner ear with Ménière’s syndrome.  It is clear that Ménière’s disease has undergone a progressive development, from inner ear hemorrhage to membranous effusion to a specific definition, which allows us to have a more specific understanding of the disease and to avoid the bias that “vertigo is Ménière’s disease and Ménière’s disease is membranous effusion”.