We recommend the use of the shift upward to 1000 Hz with a caloric asymmetry as the clinical protocol to maximize the use of the cVEMP threshold-response curve for assistance in the identification of MD, in the context of a ≥25% caloric asymmetry. This implies that if the test is negative no interpretation of identification of MD can be made. If the test is positive the results can be used to increase the argument for MD since the probability of the result being a false positive is only 5-10%.

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Purpose Ménière's disease (MD) is a constellation of otologic symptoms that includes aural fullness, tinnitus, hearing loss, and episodic vertigo. Even though the criteria for diagnosing the disorder was set forth in 1972, the causes are still not well understood. The purpose of this study was to describe the relationships between tests of hearing and vestibular function and length of time patients diagnosed with unilateral MD have experienced symptoms. Method The charts of 254 patients with definite unilateral MD from the Mayo Clinic database were retrospectively reviewed. In order to be included, patients must have reported active MD diagnosis within the previous 5 years. Main outcome measures were results for audiometry, cervical vestibular evoked myogenic potentials, ocular vestibular evoked myogenic potentials, caloric test findings, video head impulse test, and sinusoidal harmonic acceleration. Results Results indicate there is a significant effect of the duration of MD symptoms reported by the patient and findings on some tests of hearing and vestibular function. Specifically, pure-tone average, caloric paresis, and rotational chair phase were all positively correlated with duration of symptoms. Rotational chair gain was found to have an inverse relationship with time. We did not find that video head impulse test gain or certain vestibular evoked myogenic potential measures were significantly correlated with the reported duration of patient symptoms. Conclusions Our results suggest that, although the duration of symptoms reported by the patient does correlate with a number of vestibular and hearing tests, the relationships are relatively weak. The number of attacks and severity of symptoms should be investigated to determine if they are better predictors of laboratory testing results in the patient with MD.