Hearing in Menière's Disease: A Study of Pure-Tone Audiograms in 334 Patients

Abstract

HEARING IN MENIBRES DISEASE A S t u d y of P u r e -T o n e A u d i o g r a n i s i n 334 P a t i e n t sIn 334 patients with Menibre's disease the pure-tone audiograms were analysed, and the age at onset, onset symptoms and bilaterality were studied. The flat curve was niost coninion ( S O % ) , followed next by the rising curve (17%) and then the falling curve ( 1 2 % ) . The average hearing loss for the whole material was 52 dB. Patients with flat, rising and falling curves had hearing loss of approximately the same order of magnitude. Patients with rising and trough curves had, on the average, the shortest duration of disease. The hearing loss progressed most rapidly during the first year of the disease, after which only minor deterioration took place. The mean age for patients with falling curves was on the whole the same as for the whole material.Fluctuation of the auditory threshold was recorded with all types of curves, but was somewhat more common with rising and trough curves. Fluctuations were recorded in approximately half of the patients, regardless of the duration of the disease, and they were noted more often within the frequency range 250-1000 Hz than at higher frequencies.The average size of the recorded fluctuations was 20-30 dB, this being independent, on the whole, of the frequency range.The disease was bilateral in 14%. In half of these cases the second ear was involved either simultaneously or during the first year of illness. In the other half the second ear was affected after varying intervals of up to 20 years. In 77% of the patients the disease was manifested before the age of 51 years. The most coninion forni of onset of the disease was simultaneous hearing loss and vertigo. Vertigo alone as the onset syniptom was noted in 37% of the patients, and hearing loss in 22%. In twothirds of the latter patients the first vertigo attack occurred after an interval of one year or longer.

Clinical and Audio Vestibular Profile of Meniere’s Disease in a Tertiary Care Centre in India

“…Literature reports stabilization of hearing loss after a year of deterioration [9], while our experience has been progressively worsening in half the patients although they had been suffering from the disease for many years. Deterioration of hearing levels are seen initially in the low frequencies especially in patients with unilateral disease [10].…”

Magnetic Resonance Imaging of Endolymphatic Sac in Acute Low-Tone Sensorineural Hearing Loss without Vertigo

“…= Sum of the hearing levels at 125, 250, and 500 Hz; HT3 = sum of the hearing levels at 2,000, 4,000, and 8,000 Hz; A = affected side; U = unaffected side; B = bilateral sides; N = negative. 1 Period between onset of hearing loss and MRI, days. 2 In these patients, complete recovery was obtained from the first occurrence of ALHL.…”

“…ALHL can be caused by various diseases, such as acoustic tumors, vascular disease, the early stages of Mé-nière's disease [1][2][3], after lumbar puncture, and so on. In the present study, acoustic tumor or ALHL with vertigo were excluded from the study.…”

“…However, the cause is unknown in most cases. ALHL frequently occurs during the early stages of Mé-nière's disease [1][2][3]. In 1982, Abe [4] reported that 39 patients with ALHL of unknown origin showed complete recovery of hearing, without fluctuation or recurrence.…”

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

“…MD classically produces a fluctuating low frequency hearing loss that becomes permanent as the disease progresses. However, it can cause many other patterns of hearing loss, which may mimic differentials such as otosclerosis, or noise induced losses [4]. …”