Comparative clinical features of unilateral and bilateral Ménière's disease

Ménière's disease (MD) is an inner ear disorder, primarily unilateral but sometimes bilateral. Their comparative clinical profiles are not fully defined.

To compare the clinical characteristics of unilateral Ménière's disease (UMD) and bilateral Ménière's disease (BMD).

A retrospective analysis of UMD and BMD patients was conducted. Statistical analyses included the Wilcoxon rank-sum test, Spearman's correlation, and Fisher's exact test to compare clinical parameters and their associations with endolymphatic hydrops (EH).

In UMD, vertigo attack frequency correlated positively with overall EH degree, vestibular EH grade, and the number of involved sites, while vertigo attack duration correlated negatively with low-frequency hearing, vertigo duration showed no consistent correlation with most EH parameters except for a weak positive correlation with vestibular EH grade. In BMD, synchronous bilateral onset occurred in 59% and asynchronous onset in 41%. Hearing loss duration correlated with hearing loss thresholds in both ears, but most vertigo features showed no significant associations with EH characteristics Notably, however, vertigo duration was moderately negatively correlated with cochlear EH grade and the number of EH-involved sites in the second ear. Furthermore, vertigo onset was more frequently delayed in BMD, while UMD showed more synchronous vertigo and hearing loss onset.

UMD and BMD exhibit distinct clinicopathological patterns. Early MRI evaluation is essential for atypical cases(e.g., delayed-onset vertigo or asynchronous bilateral symptoms) to avoid misdiagnosis.