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<b><i>Background:</i></b> The progression of hearing impairment and the bilateral involvement of Meniere’s disease (MD) may depend on the disease duration and aging. Recent studies reported that MD might involve dysfunction of the microvascular circulation damaged due to inflammatory changes. <b><i>Objectives:</i></b> The aim of this study was to determine that the progress of the MD’s hearing impairment and bilateral disability may be associated with the pathogenesis of several pro-inflammatory processes. <b><i>Patients and Methods:</i></b> We recruited 30 unilateral MD patients (56.8 ± 14.7 years old), 7 bilateral MD patients (65.3 ± 13.9 years old), and 17 age-matched control subjects (53.5 ± 14.4 years old, <i>p</i> &#x3e; 0.05). We measured the plasma vascular endothelial growth factor (VEGF), plasma interleukin-6 (IL-6), plasma tumor-necrosis factor α (TNFα), and plasma monocyte chemotactic protein-1 (MCP-1). <b><i>Results:</i></b> The bilateral MD group and the unilateral MD group had higher plasma MCP-1 (204.7 ± 41.0 pg/mL and 169.5 ± 32.0 pg/mL) than the control group (149.2 ± 30.7 pg/mL) (<i>p</i> &#x3c; 0.05). There was no significant difference in plasma TNFα, IL-6, and VEGF among 3 groups (<i>p</i> &#x3e; 0.05). There was a strong correlation between the plasma MCP-1 and age in MD patients (<i>r</i> = 0.58, <i>p</i> &#x3c; 0.01); however, no significant correlation between the plasma MCP-1 and age was found in control subjects (<i>p</i> &#x3e; 0.05). The plasma MCP-1 significantly correlated with the average hearing level of 500, 1,000, 2,000, and 4,000 Hz, and the maximum slow phase eye velocity in caloric test in the better side (<i>p</i> &#x3c; 0.05). Also, the plasma MCP-1 showed significant positive correlations with the plasma IL-6 (<i>r</i> = 0.49, <i>p</i> &#x3c; 0.01) and plasma TNFα (<i>r</i> = 0.32, <i>p</i> &#x3c; 0.05) in MD group. <b><i>Conclusions:</i></b> Our results suggest that the increased plasma MCP-1 accompanying pro-inflammatory processes are associated with the progression of the hearing impairment and the bilateral disability of MD.

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ObjectivesNo clinically useful prognostic factors have been identified for idiopathic sudden sensorineural hearing loss (ISSNHL). The current study therefore sought to identify useful prognostic factors for idiopathic sudden sensorineural hearing loss from blood biomarkers while attempting to classify the pathogenic mechanism and formulate treatment strategies based on these results.Study DesignProspective cohort study.SettingTertiary referral center.MethodsA total of 47 patients with acute phase ISSNHL were treated with steroid at an initial dose of 1 mg/kg/day and hyperbaric oxygen therapy and followed up for 6 months. Serum fibrinogen levels, peripheral blood mononu- clear cells (PBMCs), and interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α production levels from PBMCs were measured, after which patient’s pre- and post- treatment hearing was compared.ResultsIn the overall cohort, the mean improvement level, mean recovery rate, and mean fibrinogen level was 20.3 dB, 46.2%, 292.0 mg/mL, respectively. The mean levels of IL-1β, IL-6, and TNF-α produced by peripheral blood mononu- clear cells cultured under lipopolysaccharide stimulation were 318.4, 498.1, and 857.6 pg/mL, respectively. High fibrinogen levels were associated with poor hearing progno- sis. Lipopolysaccharide-stimulated cytokine production by PBMCs did not correlate with hearing changes; however, the prognosis was significantly better in patients with low fibrinogen levels and high IL-1β levels produced by PBMCs than in other patients.ConclusionsOur results suggest that patients with simple inflammatory-type ISSNHL responded well to standard therapy. Therefore, serum fibrinogen levels and PBMCs cytokine production may help determine the management of ISSNHL based on its pathogenic mechanism.