1993 Volume 86 Issue 7 Pages 951-956
Over a 10-year period, two patients with a diagnosis of sudden deafness without vertigo and 15 patients with a diagnosis of sudden deafness with vertigo at their first episode of hearing loss later developed definite Meniere's disease. These early Meniere's disease patients were compared with 133 patients with sudden deafness without vertigo, 71 patients with sudden deafness with vertigo, and 90 patients with definite Meniere's disease. Differences in the results of audiography, glycerol test, caloric test, and electrocochleography were assessed.
There was a significant difference in an upsloping audiogram between patients who had sudden deafness with vertigo and those with definite Meniere's disease (chi-square test: p <0.05). The latter patients often had an upsloping audiogram, while the former patients had very little as a result of high grade hearing loss. Thus, a first attack of Meniere's disease can be suspected if a patient with sudden deafness and vertigo has an upsloping audiogram. There was less hearing loss in the early and definite Meniere's disease groups than in the sudden deafness patients.
The glycerol test was positive in 27.3% of early Meniere's disease patients and in 53.3% of definite Meniere's disease patients. There was no significant difference between early Meniere's disease and the other diseases.
Five of the six early Meniere's disease patients tested had an increased negative SP/AP ratio on electrocochleography, as did 67.3% of definite Meniere's disease patients. There was a significant difference between definite Meniere's disease patients and those who had sudden deafness with or without vertigo (chi-square test: p <0.05). Although there was no significant difference between early Meniere's disease patients and sudden deafness with vertigo, it seemed that electrocochleography was useful in distinguishing Meniere's disease from sudden deafness at the first episode of hearing loss.
