From the Guidelines
Meniere's disease is diagnosed based on a combination of symptoms and diagnostic tests, with a strong recommendation to obtain an audiogram when assessing a patient for the diagnosis, as stated in the clinical practice guideline by 1. The key symptoms include recurrent episodes of vertigo lasting 20 minutes to several hours, fluctuating hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the affected ear. To confirm the diagnosis, doctors typically perform:
- Audiometric testing to document hearing loss, as recommended by 1
- Vestibular function tests like electronystagmography (ENG) or video head impulse test (vHIT) to assess balance function, although these tests are not routinely recommended for diagnosis, as stated by 1
- Imaging studies such as MRI to rule out other conditions like acoustic neuroma, as suggested by 1 The diagnosis requires at least two spontaneous episodes of vertigo lasting at least 20 minutes, documented hearing loss on at least one occasion, and either tinnitus or aural fullness in the affected ear. There is no single definitive test for Meniere's disease, making it primarily a clinical diagnosis based on the pattern of symptoms and exclusion of other potential causes, as noted by 1. Early diagnosis allows for prompt treatment to manage symptoms and potentially slow disease progression. It is essential to document resolution, improvement, or worsening of vertigo, tinnitus, and hearing loss and any change in quality of life in patients with Meniere's disease, as recommended by 1.
From the Research
Meniere's Disease Diagnosis
- Meniere's disease is a disorder of the inner ear that can cause vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear 2, 3, 4.
- The diagnosis of Meniere's disease is based on a combination of clinical symptoms, medical history, and audiometric tests 2, 4, 5.
- Pure-tone audiometry is a common test used to assess hearing loss in Meniere's disease, and it can show a variety of audiogram configurations, including peak, falling, mountain, and dip types 2, 4, 5.
- The peak type audiogram is the most common configuration in Meniere's disease, and it is often characterized by a peak frequency at 2 kHz 2.
- Speech recognition tests are also important in the diagnosis and follow-up of Meniere's disease, as they can show a dissociation between pure-tone audiometry and speech recognition threshold 3.
- Machine learning models based on pure-tone audiometry features can be used to diagnose Meniere's disease and predict endolymphatic hydrops, with high accuracy and sensitivity 6.
Audiometric Characteristics
- The audiometric curve configuration in Meniere's disease can be divided into different types, including low, low + high, and flat configurations 4, 5.
- The shape of the hearing loss in Meniere's disease does not depend on the duration of the disease, and it is not correlated with the average hearing loss 4.
- The audiogram shape can be an indicator of future bilateral disease in Meniere's disease 5.
- The hearing pattern in Meniere's disease differs between unilateral and bilateral disease, with bilateral cases showing a slightly more severe hearing loss and a flatter audiometric curve 5.
Diagnostic Criteria
- The diagnosis of Meniere's disease is based on the American Academy of Otorhinolaryngology criteria, which include a combination of clinical symptoms, medical history, and audiometric tests 5.
- The definition of Meniere's disease according to the "Definition Meniere Groningen" is also used in some studies, which includes a set of specific criteria for the diagnosis of the disease 4.