Classification of patients with Ménière's disease using otoacoustic emissions.

Otoacoustic emissions (OAEs) were studied in patients with Ménière's disease in order to assess their usefulness for distinguishing between different stages of the disease. An accurate classification of Ménière's patients is expected to allow optimalization of the treatment for each particular stage. Click-evoked and distortion product OAEs were evaluated in both ears for 70 Ménière's patients. Based on these measurements, Ménière's patients can be divided into four different categories. In patients with small hearing losses OAEs are found, whereas patients with pure-tone thresholds larger than 60 dB exhibit no OAEs at all. In the intermediate range (30- to 60-dB thresholds) two categories of patients are distinguished: patients with relatively large emissions and patients without measurable emissions. These findings suggest the presence of various stages in the pathophysiological mechanism involved in Ménière's disease. Additionally, Ménière's patients with contralateral ears with normal thresholds have significantly smaller emissions than normal-hearing adults. This observation could represent a very early manifestation of bilateral Ménière's disease, which cannot be detected by other diagnostic methods.