Comparative Study of Acute Low-Tone Sensorineural Hearing Loss and Ménière’s Disease

Abstract

Involvement of endolymphatic hydrops has been reported in both Ménière’s disease (MD) and acute low-tone sensorineural hearing loss (ALHL). However, only a few studies have been conducted to compare the two conditions in respect of the involvement of endolymphatic hydrops. For this research, I extracted the medical records of patients who fulfilled the diagnostic criteria for MD and ALHL among patients who visited my clinic for dizziness or hearing loss over the past seven years. I then conducted a retrospective analysis of the patient data, including the age at the time of the initial visit, gender, affected side, hearing level, subjective symptoms, presence/absence of nystagmus, tendency to develop MD, etc. There were 108 cases with 110 ears diagnosed as having MD (definite), including 29 cases in men (26.9%) and 79 cases in women (73.1%), 163 cases with ALHL, including 41 cases in men (25.2%) and 122 cases in women (74.8%), and 31 cases with cochlear MD, including 5 cases in men (16.1%) and 26 cases in women (83.9%). The male-female ratio was 1:5.2 for patients with cochlear MD, 1:3.0 for patients with ALHL, and 1:2.7 for patients with MD (definite). The average ages of the above patient groups were as follows: MD (definite), 45.1±14.1 years; cochlear MD, 38.8±14.2 years; ALHL, 46.9±15.5 years. There was no significant age difference between the patients with MD (definite) and those with ALHL. There were 31 cases (15.3%) in which the diagnosis changed from ALHL to cochlear MD and 8 cases (4.0%) in which the diagnosis changed from ALHL to MD (definite). The diagnosis changed from ALHL to cochlear MD or MD (definite) more frequently in women than in men; in particular, all of the patients in whom the diagnosis changed from ALHL to MD (definite) were woman. There were no significant differences among the three patient groups in the total hearing levels for three low frequencies (125 Hz, 250 Hz, 500 Hz) at the initial visit. The average age of the patients in whom the diagnosis changed from ALHL to MD (definite) tended to be higher (53.7±18.3), whereas those of the patients in whom the diagnosis changed to cochlear MD tended to be lower (38.8±14.2). Of the patients with MD (definite), 77.8% already had hearing loss at the time of their clinic visit. On the other hand, only 20.4% of patients had nystagmus or dizziness at the first visit. The results of this study revealed that most patients with ALHL and MD were already aware of hearing loss or the sensation of clogged ears.