1) Ten cases (fourteen ears) with fluctuant hearing loss without vertigo were clinically investigated.
2) Hearing loss was seen in low and middle frequencies with positive recruitment. Degree of hearing fluctuation was, in most cases, between 20 and 40dB. Durations between the shift of hearing loss were various in each case, and there was no relation of fluctuating hearing loss to a particular season.
3) Four cases of fluctuant hearing loss without vertigo were firstly diagnosed as Ménière's disease.
4) Though vertigo was not observed in these cases with fluctuant hearing loss, most casès showed abnormal findings in equilibrium examinations. In caloric test unilateral hypofunction was observed in 60%. While in damped pendular rotationtest, 57% showed abnormal findings suggesting dysfunction or circulatory disturbances in the brainstem.
5) Serum lipids, total cholesterol, and glucose torelance test were within normal limits. In two cases abnormal values of serum protein fraction (increase of γ- and α
2-globuline) were obtained.
It is noteworthy that in these two cases sensorineural hearing losses were improved by administration of steroid (predonine). One of these cases were proved to be aortitis syndrome by aortography.
6) Fluctuant hearing loss in these series is a syndrome which include sensori-neural hearingloss due to endolymphatic hydrops (Williams type) or local manifestation of systemic vascular disorders and psychogenic deafness. Therefore, examinations should include not only audiological and vestibular tests but also systemic examinations (BSR, serological tests, endocrine tests, etc.) and studies from psychosomatic standpoint.
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