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Pressure test for the diagnosis of Menière's disease
M Kitahara1, A Kodama, H Ozawa
1Department of Otolaryngology, Shiga University of Medical Science, Otsu, Japan.
Abstract:
In the last 15 years, a pressure chamber able to generate negative air pressure has been used to treat patients with Menière's disease. In this study we sought to clarify whether the underpressure chamber can be used to diagnose Menière's disease. We studied 45 ears from patients with neurotological diseases. The subjects were placed supine in a soundproof pressure chamber. The pressure was first decreased to -500 mmH2O, and after 5 min to -700 mmH2O. The pressure was kept at this level for another 5 min and then increased to 0 mmH2O. This procedure was done three times in succession. While the chamber pressure was below 0 mmH2O, the subjects were instructed to abstain from actively equilibrating middle ear pressure. When the chamber pressure was raised to 0 mmH2O, they were instructed to equilibrate middle ear pressure, and if necessary Politzerization or catheterization of the Eustachian tube was done. As a result, hearing was improved after this procedure only in patients with Menière's disease (50%) and/or cochlear Menière's disease (32%) in which endolymphatic hydrops was suspected.
Insights
The negative air pressure chamber, used for Menière's disease treatment, may aid diagnosis. Hearing improved post-procedure only in patients with Menière's disease or cochlear Menière's disease, suggesting endolymphatic hydrops.
Area of Science:
- Otolaryngology
- Neurotology
Background:
- The negative air pressure chamber has been utilized for Menière's disease treatment.
- Its diagnostic potential for Menière's disease remains unclear.
Purpose of the Study:
- To investigate the diagnostic utility of the negative air pressure chamber for Menière's disease.
Main Methods:
- 45 ears from patients with neurotological diseases were studied.
- Subjects underwent a procedure involving sequential negative air pressure exposure (-500 to -700 mmH2O) in a soundproof chamber.
- Middle ear pressure equilibration and interventions were performed upon return to ambient pressure.
Main Results:
- Hearing improvement was observed exclusively in patients diagnosed with Menière's disease (50%) and cochlear Menière's disease (32%).
- These patient groups were suspected of having endolymphatic hydrops.
Conclusions:
- The negative air pressure chamber shows potential as a diagnostic tool for Menière's disease.
- The observed hearing improvement correlates with suspected endolymphatic hydrops.