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


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.
Chen
Chun-Nan
CN
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Young
Yi-Ho
YH
D000328:Adult; D000368:Aged; D000465:Algorithms; D001301:Audiometry, Pure-Tone; D003937:Diagnosis, Differential; D005072:Evoked Potentials, Auditory / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D003639:Hearing Loss, Sudden / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D017084:Otoacoustic Emissions, Spontaneous / Q000502:physiology; D014724:Vestibular Function Tests