Task force of the Brazilian Society of Otology and the Brazilian Academy of Neurotology: Menière’s Disease
OBJECTIVE: To critically review the available evidence on the pathophysiology and diagnosis of Menière's disease and to provide consensus-based recommendations developed by a task force of the Brazilian Society of Otology and the Brazilian Academy of Neurotology. METHODS: A task force consisting of experts in otology and neurotology was established to review the scientific literature and develop thematic sections of the document. The content was discussed in both in-person and remote meetings until consensus was achieved. Recommendations were graded according to level of evidence and strength of recommendation using standardized systems for the evaluation of therapeutic interventions and diagnostic methods. RESULTS: Menière's disease is a heterogeneous clinical condition characterized by recurrent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic hydrops represents the most consistent histopathologic finding; however, it does not alone explain the clinical expression of the disease. Current evidence indicates the involvement of multifactorial mechanisms, including genetic predisposition, immune dysfunction, inflammatory processes, and changes in inner ear ion homeostasis. Diagnosis remains primarily clinical, based on international criteria, with serial audiometry playing a key role. Electrophysiologic testing and imaging may be useful in selected situations. Clinical variability supports the concept of subphenotypes with potential diagnostic and prognostic implications. CONCLUSION: Menière's disease should be recognized as a heterogeneous and multifactorial clinical entity. Diagnosis requires careful clinical evaluation and longitudinal follow-up. Advances in the understanding of pathophysiologic mechanisms and the identification of subphenotypes may contribute to more individualized diagnostic and therapeutic strategies.
Authors
- Mariana Moreira de Castro Denaro (ORCID: https://orcid.org/0000-0003-4331-6438)
- Carlos Takahiro Chone (ORCID: https://orcid.org/0000-0002-4217-4629)
- Vanessa Mazanek Santos (ORCID: https://orcid.org/0000-0003-4106-330X)
- Roberto Miquelino de Oliveira Beck (ORCID: https://orcid.org/0000-0003-3516-792X)
- Joel Lavinsky (ORCID: https://orcid.org/0000-0002-0377-5704)
- Pauliana Lamounier (ORCID: https://orcid.org/0000-0003-3552-5264)
- Henrique Furlan Pauna (ORCID: https://orcid.org/0000-0002-5575-7030)
- Lúcia Joffily (ORCID: https://orcid.org/0000-0002-8446-7083)
- Camila de Giacomo Carneiro Barros (ORCID: https://orcid.org/0000-0003-3101-335X)
- Rogério Castro Borges de Carvalho (ORCID: https://orcid.org/0000-0002-9049-8142)
- Paula Lobo Furtado (ORCID: https://orcid.org/0009-0004-5471-7426)
- Rogério de Azevedo Hamerschmidt (ORCID: https://orcid.org/0000-0002-7722-6409)
- Raquel Mezzalira (ORCID: https://orcid.org/0000-0002-0279-8007)
- Fábio André Selaimen (ORCID: https://orcid.org/0000-0002-9209-2023)
- Patrícia Mauro Mano (ORCID: https://orcid.org/0000-0002-5702-6039)
- Lívia Noleto de Rezende Oliveira (ORCID: https://orcid.org/0000-0003-0851-1123)
- César Bertoldo (ORCID: https://orcid.org/0000-0003-1145-6831)
- Arthur Menino Castilho (ORCID: https://orcid.org/0000-0002-9024-8004)
- Lucas Resende Lucinda Mangia (ORCID: https://orcid.org/0000-0003-3443-3640)
- Signe Schuster Grasel (ORCID: https://orcid.org/0000-0003-4060-6448)
- Vagner Antônio Rodrigues da Silva (ORCID: https://orcid.org/0000-0002-7335-4489)
- Márcio Cavalcante Salmito (ORCID: https://orcid.org/0000-0001-6316-3358)
- Luíz Lavinsky (ORCID: https://orcid.org/0000-0002-6860-0147)
- Karen de Carvalho Lopes (ORCID: https://orcid.org/0000-0002-8888-0844)
- André L. L. Sampaio
- Mauricio Noschang Lopes da Silva
Institutions
- Universidade Federal do Rio Grande do Sul (BR)
- Universidade de Ribeirão Preto (BR)
- Universidade de Brasília (BR)
- Pontifícia Universidade Católica do Paraná (BR)
- Universidade de São Paulo (BR)
- Universidade Estadual de Campinas (UNICAMP) (BR)
- Hospital Universitário Gaffrée e Guinle (BR)
- Hospital de Clínicas de Porto Alegre (BR)
- Hospital Universitário Cajuru (BR)
- Hospital das Clínicas da Universidade Federal de Minas Gerais (BR)
- Hospital de Clínicas Universidade Federal do Paraná (BR)
- Hospital de Clínicas (UY)
- Universidade Federal de São Paulo (BR)
Publication Details
- Journal
- Brazilian Journal of Otorhinolaryngology
- Published
- 2026-10-14
- DOI
- https://doi.org/10.1016/j.bjorl.2026.101926
- Primary Topic
- Vestibular and auditory disorders
- Type
- article
- Field-Weighted Citation Impact
- 0.00