Ménière's diseasenot only includes the symptom complex consisting of attacks of 
vertigo, low-frequency hearing loss, and tinnitus but comprises symptoms related 
to the eustachian tube, the upper cervical spine, the temporomandibular joints, 
and the autonomic nervous system. Quantifiable experience shows that the 
insertion of a middle-ear ventilation tube can alleviate Ménière's disease 
symptoms, suggesting that eustachian tube dysfunction is a contributing feature. 
Clinical practice also shows that treating disorders of the upper cervical spine 
and temporomandibular joints can lessen Ménière's disease symptoms, suggesting a 
relationship. Similarly, stellate ganglion blocks can be beneficial in 
controlling Ménière's disease symptoms, highlighting the influence of the 
autonomic nervous system. Thus, contrasting symptoms associated with the 
eustachian tube, the upper cervical spine, the temporomandibular joints, and the 
autonomic nervous system relate to Ménière's disease, but the possible reflex 
pathway by which a link is established is unclear. We made an attempt in this 
study to describe a hypothetical reflex pathway that links joint injury and the 
autonomic nervous system, where eustachian tube function is under their 
influence and is the critical link. In this hypothetical reflex pathway, 
irritation of facet joints can first lead to an activated anterior cervical 
sympathetic system via an independent pathway in the mediolateral cell column; 
it can simultaneously lead to an axon reflex involving nociceptive neurons, 
resulting in neurogenic inflammation and the prospect of a eustachian tube 
dysfunction. The eustachian tube dysfunction is responsible for a disturbed 
middle ear-inner ear pressure relationship, circumstances that have the 
potential to develop into secondary Ménière's disease. This reflex pathway is 
supported by recent animal experiments.