Cochlear conductive hearing loss in patients with Meniere's disease

Physiological studies with experimental models of endolymphatic hydrops in Meniere's disease demonstrate some pressure changes at the level of round and oval window. Interestingly, conductive type hearing loss was observed in some patients during Meniere episodes. A close auditory follow-up of these patients may provide a better understanding of hydrodynamic changes of the hydrops and micromechanics of the inner ear.

Eighty-four patients (mean age 34.3 years; range 17 to 77 years) with Meniere's disease were enrolled in the study. Duration of Meniere symptoms ranged between six months to 22 years (mean 6.2 years). Longitudinal follow-up of patients was planned for three years. Bone and air conduction thresholds were averaged and the differences between the thresholds were calculated.

Twenty-four patients (28.4%) demonstrated air-bone gap at least at one frequency, the differences being 18.3, 11.8, 2.8, and 11.1 dB at 0.5, 1, 2, and 4 kHz, respectively. The average air-bone gap was 11.5 dB. The difference was the greatest at 0.5 kHz and the least at 2 kHz.

Low-frequency conductive hearing loss may be detected in Meniere's disease, which is apparently not indicative of middle ear pathology. High incidence of conductive involvement in patients who have had a recent episode of vertigo may indicate a distortion of vibratory movement of the stapes.