In the course of Meniere's disease (MD), approximately one third of patients progress from unilateral to bilateral MD. For optimal treatment, the potential risk for contralateral ear involvement should be properly assessed. This study aimed to explore factors predicting progression from unilateral to bilateral Meniere's disease.
Clinical records of 180 consecutive patients with definite MD were reviewed. Patients were classified into the following 3 groups: patients with unilateral MD (CEI-, contralateral ear involvement-), patients exhibiting progression from unilateral to bilateral MD (CEI+), and patients with bilateral MD at the time of first consultation (BL, bilateral). Age, gender, duration of symptoms, stage of disease, left-right difference on caloric test, results of vestibular-evoked myogenic potential (VEMP) recording, subjective visual horizontal, and time to remission of vertigo attacks were compared.
When stages 1 with 2 and 3 with 4 were combined, there were more cases of stage 3 or 4 disease in both the CEI+ and BL groups than in the CEI- group. On VEMP responses, the proportions of patients exhibiting normal responses on both sides or absent responses on both sides in the CEI+ and BL groups were larger than those in the CEI- group. In a regression analysis, stage 3 or 4 and lack of left-right difference in the VEMP response were factors significantly associated with contralateral ear involvement.
In patients with unilateral MD, stage 3 or 4 disease and lack of any left-right difference in the VEMP responses at initial examination were risk factors for contralateral ear involvement.
