The Furosemide Test and Vestibular Status in Meniere's Disease

Abstract

A total of 62 ears of patients with typical Meniere's disease was examined by the furosemide test to detect endolymphatic hydrops. In 95% of the normal control group, the per cent change in the maximum velocity of the slow phase of caloric nystagmus (MVS) after injection of furosemide was under 10%. Therefore, a positive furosemide test was defined as a change in MVS of more than 10%. Thirty-five (56%) of the 62 ears with typical Meniere's disease showed a positive furosemide test. When the affected ears were divided into two groups according to vestibular symptoms, only 11 (38%) of 29 inactive ears were positive while 24 (73%) of 33 active ears were positive. There was a significant difference in the positive rate of the furosemide test between the ears with clinically inactive and active vestibular disease. The per cent canal paresis (CP%) was determined to assess canal excitability and a CP%>25% was defined as canal paresis. There was no significant difference in the furosemide test positive rate between ears with canal paresis and ears with a normal CP%, although the former tended to show a greater MVS change. The response to the furosemide test showed no relationship to the results of pure tone audiometry. In conclusion, the furosemide test appears to indicate the vestibular status in various stages of Ménière's disease.