The treatment of Meniere's syndrome has been the topic of many articles. Even special meetings of societies have devoted their attention to this disorder. Typically, more questions are raised than conclusions reached. See also p 491. In the past, guidelines and agreedon criteria were developed for Meniere's syndrome to allow accuracy of diagnosis and measurement of treatment success. The new information we regularly receive through professional publications and activities can cause us to pause and review the current validity of these guidelines and criteria. Information of the last decade leads to the possibility of several causes and/or pathophysiologic processes. Allergy, granulomatous disorders, and perilymphatic dynamics are, at times, indicated as possible different causes of the triad of Meniere's syndrome. The role of the endolymphatic sac in idiopathic labyrinthine hydrops now seems to be indisputable. Is this always true in each of the possible causative pathways? If several causes for a