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Meniere disease subtyping: the direction of diagnosis and treatment in the future
Sulin Zhang1,2, Zhaoqi Guo1, E Tian1
1Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Introduction:
Meniere's disease (MD) is a chronic disorder of inner ear, characterized by audial and vestibular symptoms. It presents a great variability among patients in terms of clinical features, etiology, pathology, and response to the same therapy. It's challenging to diagnose and manage for its heterogeneity. Indeed, the consensus is reached that MD has subtypes. Identifying subtypes of MD is important for individualized therapy and further research.
Areas Covered:
In this review, we examined the heterogeneity of MD. We also included the valid subtyping solutions and updated data regarding the association among subtypes, disease progression, and management.
Expert Opinion:
MD is an etiologically multifactorial condition, and it might be a constellation of symptoms associated with endolymph hydrops, not a disease entity. So far, MD can be classified as distinct phenotypes and endotype, respectively based on symptoms, pathology, possible etiology, and co-existing condition. Patients in different subtypes present different clinical features and are suitable for different treatment. The identification of these subtypes will benefit both basic and clinical studies of MD, by helping achieve personalized therapy, accurate prognosis prediction and even disease screening in near future. Therefore, MD subtyping is the emerging direction of diagnosis and treatment in the future.
Insights
Meniere
Area of Science:
- Neurology
- Otolaryngology
Background:
- Meniere's disease (MD) is a chronic inner ear disorder with variable symptoms, etiology, and treatment responses.
- The heterogeneity of MD presents diagnostic and management challenges, leading to the consensus of distinct MD subtypes.
- Identifying MD subtypes is crucial for personalized treatment strategies and advancing research.
Purpose of the Study:
- To review the heterogeneity of Meniere's disease.
- To examine valid subtyping solutions for MD.
- To update data on the relationship between MD subtypes, disease progression, and management.
Main Methods:
- Literature review focusing on MD heterogeneity.
- Analysis of existing MD subtyping classifications.
- Inclusion of current data on subtype associations with progression and treatment.
Main Results:
- Meniere's disease is etiologically multifactorial, potentially a symptom complex rather than a distinct disease.
- MD can be classified into distinct phenotypes and endotypes based on symptoms, pathology, etiology, and comorbidities.
- Different MD subtypes exhibit varying clinical features and require tailored therapeutic approaches.
Conclusions:
- Subtyping Meniere's disease is essential for personalized therapy, prognosis prediction, and future screening.
- MD subtyping represents a significant emerging direction in the diagnosis and treatment of this complex disorder.
- Recognizing MD subtypes facilitates targeted research and clinical management.
