Does ‘Cochlear Ménière’s Disease’ Exist? An Electrocochleographic and Audiometric Study

Abstract

Introduction: According to current diagnostic criteria, patients exhibiting only cochlear symptoms without vertigo cannot be diagnosed with Ménière’s disease (MD). The recently reported Ménière’s Disease Index (MDI) combines audiometric and electrocochleographic parameters in a multidimensional measure correlating with the clinical degrees of MD. Materials and Methods: Twenty-one patients with hearing loss, tinnitus and aural fullness, but without vertigo, underwent transtympanic electrocochleography. Based on the previously reported formula, the MDI value for every patient was calculated. Results: Mean MDI value was 5.7 on a scale from 0 (mean value of non-MD patients) to 10 (mean value of definite MD patients). Conclusions: We can thus hypothesize that, based on audiometry and electrocochleography, ‘cochlear MD’ patients may represent a separate clinical entity with Ménière-like pathophysiology or underlying endolymphatic hydrops.

Recent surgical options for vestibular vertigo

“…Since then, there are several disease entities with a manifold and partly confusing terminology that are associated with ELH: cochlear and vestibular Menière’s disease, monosymptomatic Menière’s disease etc. [ 4 ], [ 15 ], [ 16 ], [ 17 ]. Even if ELH is known to be the cause for the symptoms of MM for a long time, guidelines still recommend diagnosis based on medical history, audiometry, and the principle of exclusion diagnostics [ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ].…”

Ménière’s Disease and Tinnitus

“…Current AAO-HNS deinitions do not allow this possibility [22], but there is some evidence that it might exists [28][29][30], so it opens a window for the establishment of a tinnitus subtype. According to some authors, MD may begin with cochlear symptoms only, which may be atributed to other diseases related to hearing loss [30].…”

“…The Ménière's Disease Index (MDI) was developed as an objective correlation of MD, based on audiometric (pure-tone audiometry air threshold at 125 Hz and pure-tone audiometry air threshold at 8000 Hz) and transtympanic electrocochleography (summation potential amplitude at 4000 Hz) data [28]. A recent study evaluated the MDI scores in patients with audiological symptoms and without vertigo, concluding that the 'cochlear MD' patients may represent a separate clinical entity, with MD's resembling pathophysiology and/or endolymphatic hydrops ('Ménière-like') [29]. A typical case is represented below.…”

Delayed post gadolinium MRI descriptors for Meniere’s disease: a systematic review and meta-analysis

“…A series of diagnostic criteria have been proposed by international societies, most recently in 1995 and 2015 [ 4 , 6 ], which are largely based on the subjective reporting of symptoms and audiometry [ 2 – 8 ]. However, MD may have variable manifestations, with the cardinal symptoms present in only 40% of patients with early disease [ 9 , 10 ]. The ability of clinical criteria to capture atypical phenotypes [ 11 ] and to distinguish MD from alternative diagnoses has also been questioned [ 8 , 12 , 13 ].…”