The Ménière's Disease Index

Abstract

Diagnosis of Ménière's disease (MD) is made according to the diagnostic criteria proposed by the American Academy of Otolaryngology-Head and Neck Surgery. Value of transtympanic electrocochleography (TT-ECoG) in diagnosis of endolymphatic hydrops remains controversial. The aim of our study is to determine which combination of audiometric and electrocochleographic measures correlates best with the clinical diagnosis of endolymphatic hydrops. Retrospective analysis of 109 consecutive patients undergoing TT-ECoG. All 131 tested ears were divided in categories: definite MD, probable MD, possible MD, and non-MD, according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery. TT-ECoG was performed using clicks and tone burst stimuli. Audiometric and electrocochleographic data were collected and analyzed. TT-ECoG with tone burst stimuli correctly identified 91% of the definite MD group and 71% of the non-MD group. Using binary logistic regression followed by discriminant analysis, we found a linear combination of 3 variables (air-conduction threshold at 125 and 8,000 Hz, and TT-ECoG summating potential amplitude at 4,000 Hz) that showed a good correlation with the clinical diagnosis of definite MD. This combination was able to identify 98% of the non-MD cases and 94% of the definite MD cases. The Ménière's Disease Index was created to scale the degree of MD from 0 (non-MD) to 10 (definite MD). The Ménière's Disease Index is an objective measure that correlates with the clinical degrees of MD. Future validation is still needed to confirm the added diagnostic and clinical value of this method.