Bilaterality of Meniere's Disease

Abstract

The audiometric configurations of a randomly selected group of 360 patients with clinical Meniere's disease were analysed in conjunction with their clinical manifestations. Although 78.6% of the patients had an abnormal pure-tone audiogram in the opposite ear from that which was initially diagnosed as Meniere's disease, based on the entire clinical picture, the disease was found to be definitely bilateral in 32% of the patients. A peaking audiogram type was found to be most common, occurring in about half of the involved ears. In approximately half of those with bilateral disease the second ear became involved within two years of onset of involvement of the first ear, and in another 27% the second ear became involved after a period of 5 years or more. These observations stress the importance of conservation in managing Meniere's disease, especially when considering surgical intervention for intractable disease, with the hope of retaining or restoring labyrinthine function.

Ménière’s Disease Is a Viral Neuropathy

“…Bilaterality has been reported to occur in 15-50% of patients with MD [29][30][31] . Therefore, when the virus load reaches a critical level, reactivation from latency overcomes the host immune response with the release of viral nucleic acids.…”

A Diagnostic Test for Ménière's Disease and Cochlear Hydrops: Impaired High-Pass Noise Masking of Auditory Brainstem Responses

“…However, three of the opposite ears had short delays (-0.15, +0.15, 0.0 ms; mean, 0.0 ms) that may signal the onset or actual involvement of Ménière's disease. Although studies vary considerably in terms of bilateral involvement, Paparella and Griebie (41) estimated that approximately 32% of Ménière's cases become bilateral, and Conlon and Gibson (42) suggest that ''. a high percentage of patients who have what appears to be unilateral Ménière's disease have evidence of endolymphatic hydrops in the contralateral asymptomatic ear.''…”

Multifrequency Admittancemetry in Ménière's Disease: A Preliminary Study for a New Diagnostic Test

“…The reported frequency of bilateral forms varies from 2.3% for Castellano (12) to 78% for Jongkees et al (13), perhaps because diagnostic criteria differ widely and because follow-up is limited. Using clinical criteria, Paparella and Griebie (14) found a 32% rate of bilaterality in which half of the bilateral forms began in the first 2 years. A postmortem study reported by Yazawa and Kithara (15) of 67 subjects presenting with MD showed that there was hydrops in 93% of cases and that it was then bilateral in 30% of cases.…”