Localization and prevalence of hydrops formation in Ménière's disease using a test battery

This study investigated the localization and prevalence of hydrops formation in 20 patients with unilateral Ménière's disease using a battery of tests, including audiometry, caloric, ocular vestibular evoked myogenic potential (oVEMP) and cervical VEMP (cVEMP) tests. The latter two tests used air-conducted sound (ACS) and bone-conducted vibration (BCV) as stimuli. Thirteen patients (65%) had abnormal hearing with a 4-tone average >26 dBHL. In the caloric test, 4 patients (20%) had abnormal responses, including canal paresis in 3 and caloric areflexia in 1 patient. The percentages of patients with abnormal ACS-oVEMP, BCV-oVEMP, ACS-cVEMP, and BCV-cVEMP tests were 65, 25, 45, and 25% in affected ears, and 40, 0, 15, and 0% in unaffected ears, respectively. Although ACS- and BCV-oVEMP results differed significantly, ACS- and BCV-cVEMP results did not, regardless of the affected or unaffected ears. Thus, the abnormal rates for hearing, ACS-cVEMP, BCV-oVEMP, and caloric tests in affected ears were 65, 45, 25, and 20%, respectively. This decreasing order of abnormal percentages in function of the cochlea, saccule, utricle, and semicircular canals mimics the declining sequence of hydrops formation in temporal bone studies. In conclusion, an inner ear test battery comprising audiometry, caloric, oVEMP, and cVEMP tests may provide further insight into the localization and prevalence of hydrops formation in Ménière's disease.