Differentiating the cause of acute sensorineural hearing loss between Ménière's disease and sudden deafness

Abstract

Conclusions. Most patients with Ménière's disease (MD) reveal abnormal vestibular-evoked myogenic potentials (VEMPs) and the recruitment phenomenon, whereas most sudden deafness patients display normal VEMPs without the recruitment phenomenon. We therefore recommend using both the recruitment phenomenon and VEMP testing as a diagnostic algorithm to differentiate between MD and sudden deafness as the cause of acute hearing loss. Objective. To recommend a diagnostic algorithm to differentiate between MD and sudden deafness as the cause of acute hearing loss. Material and methods. Between January 2002 and December 2003, 14 consecutive patients with “probable” MD who also had acute sensorineural hearing loss were enrolled in the study, together with another 14 age- and sex-matched patients with idiopathic sudden deafness. Each patient underwent a battery of audiovestibular function tests, including pure-tone audiometry, a stapedial reflex test, distortion-product otoacoustic emissions (DPOAEs), electronystagmography and a VEMP test. All patients were followed for at least 12 months after presentation. Results. Significant differences were found between MD and sudden deafness in terms of the recruitment phenomenon (86% and 21% of cases, respectively) and abnormal VEMP responses (71% and 21% of cases, respectively). However, the diseases did not differ significantly in terms of abnormal DPOAEs or caloric test results.