P Düwel1, L E Walther, J Ilgner, M Westhofen. 1. Klinik für Hals-, Nasen- und Ohrenheilkunde und Plastische Kopf- und Halschirurgie des Universitätsklinikum Aachen. pduewel@ukaachen.de
Abstract
INTRODUCTION: Since Dohlmann's investigations the extremely variable interindividual natural course of Menière's disease has been documented. The description of sub-entities of Menière's disease shows, the localisation of dysfunction within the labyrinth is of considerable importance. The selective investigation of crista and macula sensor organs and its time-dependent progression even provides information for the disease's staging. METHODS: In the retrospective trial presented here, 126 patients suffering from vertigo were tested by the methods described above. 10 of these patients who showed a triad of symptoms including vertigo attacks, unilateral sudden hearing loss and tinnitus were selected for this study. All 10 patients were tested within 48 hours after the last acute vertigo attack by means of caloric irrigation and VEMPs. RESULTS: The function loss verified in saccular testing could be found in Menière's disease progression at an earlier stage than the utricular function loss. Most patients with a long history of vertigo attacks also suffered from a dysfunction of the semicircular canals. DISCUSSION: The differential testing of the otolith function is a valid tool for the recognition of early labyrinth dysfunction in Menière's disease and could lead to an earlier onset of specific therapy. It also provides the base for a differentiated staging prior to therapy planning.
INTRODUCTION: Since Dohlmann's investigations the extremely variable interindividual natural course of Menière's disease has been documented. The description of sub-entities of Menière's disease shows, the localisation of dysfunction within the labyrinth is of considerable importance. The selective investigation of crista and macula sensor organs and its time-dependent progression even provides information for the disease's staging. METHODS: In the retrospective trial presented here, 126 patients suffering from vertigo were tested by the methods described above. 10 of these patients who showed a triad of symptoms including vertigo attacks, unilateral sudden hearing loss and tinnitus were selected for this study. All 10 patients were tested within 48 hours after the last acute vertigo attack by means of caloric irrigation and VEMPs. RESULTS: The function loss verified in saccular testing could be found in Menière's disease progression at an earlier stage than the utricular function loss. Most patients with a long history of vertigo attacks also suffered from a dysfunction of the semicircular canals. DISCUSSION: The differential testing of the otolith function is a valid tool for the recognition of early labyrinth dysfunction in Menière's disease and could lead to an earlier onset of specific therapy. It also provides the base for a differentiated staging prior to therapy planning.