Hearing in Menière's Disease: A Study of Pure-Tone Audiograms in 334 Patients

Abstract

This work was supported by the Swedish Medical Research Council (Project No. 17X-617–02). In 334 patients with Meniere's disease the pure-tone audiograms were analysed, and the age at onset, onset symptoms and bilaterality were studied. The flat curve was most common (60%), followed next by the rising curve (17%) and then the falling curve (12%). The average hearing loss for the whole material was 52 dB. Patients with flat, rising and falling curves had hearing loss of approximately the same order of magnitude. Patients with rising and trough curves had, on the average, the shortest duration of disease. The hearing loss progressed most rapidly during the first year of the disease, after which only minor deterioration took place. The mean age for patients with falling curves was on the whole the same as for the whole material. Fluctuation of the auditory threshold was recorded with all types of curves, but was somewhat more common with rising and trough curves. Fluctuations were recorded in approximately half of the patients, regardless of the duration of the disease, and they were noted more often within the frequency range 250–1000 Hz than at higher frequencies. The average size of the recorded fluctuations was 20–30 dB, this being independent, on the whole, of the frequency range. The disease was bilateral in 14%. In half of these cases the second ear was involved either simultaneously or during the first year of illness. In the other half the second ear was affected after varying intervals of up to 20 years. In 77% of the patients the disease was manifested before the age of 51 years. The most common form of onset of the disease was simultaneous hearing loss and vertigo. Vertigo alone as the onset symptom was noted in 37% of the patients, and hearing loss in 22%. In two-thirds of the latter patients the first vertigo attack occurred after an interval of one year or longer.