Meniere's Disease Group Research Articles

The peaked audiometric configuration in Meniere's disease: disease related?

A retrospective analysis of audiograms was completed for persons from 3 different patient groups. These 3 groups were (1) persons with unilateral Meniere's disease, (2) persons with unilateral acoustic tumor, and (3) persons from the general clinical population of an audiology clinic in a major medical center. As Paparella, McDermott, Luiz, and de Sousa (1982) also report, the most common audiometric configuration in the Meniere's disease group was peaked, a condition in which poorer hearing is reported in the low and high frequencies, and an island of better hearing sensitivity occurs at either 1.0 or 2.0 kHz. Some of the peaked audiograms from persons in our Meniere's disease group could be a result of a low-frequency hearing loss caused by Meniere's disease combined with a high-frequency hearing loss due to aging or other environmental factors. However, 27% (13/48) of the peaked audiograms in ears with Meniere's disease were found in persons with no hearing loss in the high frequencies of their nondiseased ear. Thus, the peaked audiometric configuration is associated with Meniere's disease, as suggested by research results from animals with experimentally induced endolymphatic hydrops. Peaked audiometric configurations were also observed in roughly 9% of the general clinical population and in 12.5% of ears of persons with acoustic tumors. A rule--based on the audiometric configurations that maximized identification of patients with Meniere's disease--using the general clinical population as a control did not fare as well when the tumor group was used as a control. This finding provides further evidence that peaked audiograms, although common to Meniere's disease, are not pathognomonic of this disease. Furthermore, these results indicate that the diagnosis of Meniere's disease from audiometric profiles is risky, at best.

The Relationship between Vasopressin and Endolymphatic Hydrops in the Guinea Pig

Clinical studies have shown that plasma vasopressin level is significantly elevated in patients with Meniere's disease. Other reports indicated that histamine induced a very quick and high elevation of vasopressin level and caused nystagmus in experimentally produced endolymphatic hydrops. We became interested in further investigating the details of this relationship by studying the effect of experimental endolymphatic hydrops and histamine upon plasma vasopressin level in the guinea pig. The results are as follows: 1) Histamine increased the plasma vasopressin level in normal guinea pigs. 2) There was no statistically significant difference in the plasma vasopressin level between the hydrops model and normal guinea pigs. 3) Histamine increased the plasma vasopressin level more in the hydrops model group than in normals. 4) Plasma vasopressin level was elevated in the vertiginous model caused by inner ear anesthesia. Our results support those of clinical investigators who reported that the plasma vasopressin level was elevated more in the Meniere's disease group than any other equilibrium disorder group. It is possible that vasopressin is in someway involved in the development of endolymphatic hydrops.

初回難聴発作時のメニエール病の診断

Over a 10-year period, two patients with a diagnosis of sudden deafness without vertigo and 15 patients with a diagnosis of sudden deafness with vertigo at their first episode of hearing loss later developed definite Meniere's disease. These early Meniere's disease patients were compared with 133 patients with sudden deafness without vertigo, 71 patients with sudden deafness with vertigo, and 90 patients with definite Meniere's disease. Differences in the results of audiography, glycerol test, caloric test, and electrocochleography were assessed.There was a significant difference in an upsloping audiogram between patients who had sudden deafness with vertigo and those with definite Meniere's disease (chi-square test: p <0.05). The latter patients often had an upsloping audiogram, while the former patients had very little as a result of high grade hearing loss. Thus, a first attack of Meniere's disease can be suspected if a patient with sudden deafness and vertigo has an upsloping audiogram. There was less hearing loss in the early and definite Meniere's disease groups than in the sudden deafness patients.The glycerol test was positive in 27.3% of early Meniere's disease patients and in 53.3% of definite Meniere's disease patients. There was no significant difference between early Meniere's disease and the other diseases.Five of the six early Meniere's disease patients tested had an increased negative SP/AP ratio on electrocochleography, as did 67.3% of definite Meniere's disease patients. There was a significant difference between definite Meniere's disease patients and those who had sudden deafness with or without vertigo (chi-square test: p <0.05). Although there was no significant difference between early Meniere's disease patients and sudden deafness with vertigo, it seemed that electrocochleography was useful in distinguishing Meniere's disease from sudden deafness at the first episode of hearing loss.

Vestibular Aqueduct in Meniere's Disease and Non-Meniere's Disease With Endolymphatic Hydrops : A Computer Aided Volumetric Study

The volume of the vestibular aqueduct was studied by a computer-aided volumetric method in 9 temporal bones with endolymphatic hydrops from individuals with Menière's disease (MD), 7 temporal bones with endolymphatic hydrops from individuals without a history of Meniere's disease (non-MD hydrops), and 10 normal temporal bones (controls) to investigate the cause of endolymphatic hydrops in both MD and non-MD hydrops. A hypoplastic vestibular aqueduct was found significantly more often in the MD group than in either the non-MD hydrops group (chi 2-test, chi 2 = 4.063, p less than 0.05) or the control group (chi 2-test, chi 2 = 6.363, p less than 0.05). The difference in volume between the non-MD hydrops group and the control group was not significant. It is speculated that a small vestibular aqueduct (presumably containing a small endolymphatic sac) might be a predisposing factor in Menière's disease. In contrast, in non-MD hydrops, there seems to be no correlation of endolymphatic hydrops with a hypoplastic vestibular aqueduct and endolymphatic sac.

Normal acoustic reflex amplitude growth and the influence of cochlear hearing loss

The nature of acoustic reflex amplitude ARA growth at 1KHz and 2kHz was investigated in normal hearing and cochlear disordered subjects subdivided into Meniere's Disease and heterogeneous pathology groups. Statistical and graphical analyses revealed significant inter-group variation ARA growth rate. The normal and Meniere's groups behave similarly, while the heterogeneous group demonstrated a faster ARA growth rate. The differential sensitivity of various measurement methods was examined. Explanations were put forward to account for variability in ARA data amongst cochlear disorder subjects. It was concluded that the clinical sensitivity of ARA measurement was questionable.

Electrocochleographic study of Ménière's disease (author's transl)

Meniere's disease is a disorder of both the peripheral auditory and vestibular systems.Although a considerable amount of studies has been performed on the function of both systems in Meniere's disease, there is little informations on the function of the peripheral auditory system. Electrocochleography makes it possible to measure human cochlear potentials for the study of the function of the cochlea. The action potential (AP) of 8 th nerve, the cochlear microphonics (CM) and summating potential (SP) were used as indicators for the function of the peripheval auditory system. They were recorded through a meatal skin surface electrode. An average response computor was employed. Acoustic stimuli were clicks and pure tone bursts between 0.5 kHz and 8 kHz. They were delivered to the human ear in u free field.The electrocochleographic examinations were performed on 17 ears of involved site of Meniere's disease, 13 ears with normal hearing and 35 ears with sensorineural hearing loss without dizzines. It was physiologically proved that a clickevoked inner ear potential after cancellation of CM was consisted of AP and SP.AP, SP compound potential recorded from Meniere's disease group had characteristics of a broad wave form, a large negative SP and abrupt increasing of N1 amplitude in high click intensity.This distortion of wave form of AP, SP compound potential was evaluated by measuring its width on base line and its SP/AP ratio. It was stastically significant that values of these parameters in Meniere's disease group was larger than in other two groups. (p<0.01)These results made it possible to diagnose Meniere's disease by the cochlear examination without vestibular examination.Diagnostic criteria of Meniere's disease based on electrocochleographic examination were as follows1. subjective symptome; episodic vertigo, hard of hearing and tinnitus.2. objective findings; SP/AP ratio is more than 0.43 under click intensity more than 81 dB.3. no neurological disorders except 8th nerve.All these conditions must be satisfied in order to obtain diagnosis of Meniere's disease.