[Asymmetric low-frequency hearing loss as possible cause of pressure sensation in Menière's disease]

The unilateral, low-frequency hearing loss typical of Menière's disease (MD) is often accompanied by a sensation of pressure in the ear. The pathophysiological mechanism remains unclear. The aim of this exploratory study was to investigate whether unilateral low-frequency hearing loss leads to the onset of a sensation of pressure and thus constitutes a possible mechanism for this symptom.

To simulate Menière's disease-typical hearing loss, 20 normal hearing subjects were presented binaurally with sentences of the Oldenburg Sentence Test (OLSA) with unilateral simulated low-frequency hearing loss (20, 40, 75, 100 dB HL). In two sections, a qualitative recording of unpleasant sensations was followed by randomized pair comparisons between normal hearing-, hearing loss-, and negative control-stimuli with documentation of pressure sensation and localization.

In the qualitative analysis, a sensation of pressure (71%), followed by a feeling of aural fullness (24%), was the most common perception. In the quantitative part, a sensation of pressure occurred in 75% of participants (negative control: 10%). The proportion increased significantly (p < 0.0001) from the negative control level up to 40 dB and then plateaued. In 93% of cases, the sensation of pressure was correctly attributed to the hearing loss stimulus, though it was mostly perceived contralaterally (64%).

The results indicate an association between acute asymmetric lowfrequency hearing loss and a sensation of pressure. Low-frequency hearing loss appears to be the cause of the sensation of aural pressure in MD rather than endolymphatic hydrops itself.