Prediction of Progression from Atypical to Definite Ménière's Disease Using Electrocochleography and Glycerol and Furosemide Tests

Objective: To investigate whether electrocochleography (ECochG) and glycerol and furosemide tests could predict progression from atypical to definite Ménière's disease (MD).

Material And Methods: ECochG and glycerol and furosemide tests were performed in 1569 patients with various cochleovestibular diseases, including definite MD, atypical MD, syphilitic labyrinthitis, delayed endolymphatic hydrops, sudden hearing loss, cochleovestibulopathy and sensorineural hearing loss. Patients with atypical MD were divided into five categories based on their symptoms.

Results: A total of 115/118 patients (97%) with definite MD who underwent all 3 tests showed a positive result in at least 1 test. Ninety-nine patients who did not satisfy the diagnostic criteria of definite MD but had vertigo and/or hearing loss at the first visit subsequently progressed to definite MD. It was retrospectively found that 92% of patients showed at least 1 positive finding in these 3 tests at the initial stage. In those patients who showed a negative test result in either ECochG or the glycerol test, the possibility of progression to definite MD was low.

Conclusion: The combination of ECochG and the glycerol and furosemide tests was helpful in diagnosing endolymphatic hydrops (ELH). ECochG and the glycerol test were effective tools for predicting the progression to definite MD in patients with atypical MD, sudden hearing loss and other cochleovestibular diseases. Our test results also indicated that the pathological state of atypical MD included both non-ELH and ELH.