OAEs and Meniere Disease

Abstract

Otoacoustic emissions (OAEs) are responses originating from the inner ear. Clinically they are evoked by diferent families of acoustic stimuli, such as transient acoustic clicks, tone pips, and pure tones. Upon stimulation, the acoustic energy is transformed in the middle ear at acoustic pressure acting upon the stapes footplate. The pressure wave inside the cochlea stimulates the OAE generators and a reverse acoustic energy (the OAE response) propagates from the inner ear, through the stapes and the middle ear structures, to the tympanic membrane. Considering that the acoustic energy has to cross the middle ear structures twice, the functional status of the middle ear can inluence or atenuate considerably the OAE response. In this context, any vestibular alteration can inluence the middle ear mechanics (mainly the middle ear impedance) and consequently the OAE response characteristics. The data in the literature indicate that OAEs are very sensitive to changes in the intracranial pressure. These pressure alterations during the Meniere's hydrops phase are expressed as changes in the intralabyrinthine pressure. Other studies have presented data supporting the assumption that OAEs can adequately monitor middle ear changes induced by the presentation of the glycerol test. The data in the literature suggest that OAEs can monitor the progress of Meniere's disease using reliable indices.

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“…This finding is relevant, as far as the pantonal profile may be a predictor of bilateral hearing loss. As mentioned by Hatzopoulos et al, 9 in the initial phase of the disease, the tonal audiometry revels a unilateral sensorineural hearing loss, affecting just the low frequencies. Furthermore, patients with Ménière's disease are more likely to have migraine, which may represent an endophenotype of this disease, as stated by Gazquez et al 7 Several genes have been described in single familial with the Ménière's disease including FAM136A, DTNA, PRKCB, SEMA3D, and DPT, thus suggesting genetic heterogeneity.…”