Evolution of Meniere’s Disease from MD 1.0, via MD 1.5, to MD 2.0

Abstract

Background: Elder Meniere’s disease (MD) patients ultimately lose their vestibular function.

Objective: This study utilized an inner ear test battery to investigate evolution of MD.

Methods: Total 278 elder MD patients aged >65 years were divided into three groups. Ninety-four patients with bilateral MD (188 ears) were assigned to Group A. The remaining 184 patients with unilateral MD were further divided into two groups. Group B consisted of 20 affected ears with normal vestibular function on the opposite ears, while Group C indicated 184 unaffected ears. All patients underwent an inner ear test battery.

Results: Inner ear deficits in Group B declined from the cochlea via the saccule, utricle to semicircular canals. In contrast, Groups A and C did not significantly differ in the abnormality rates of cervical vestibular-evoked myogenic potential (cVEMP), ocular VEMP and caloric tests, indicating that Group C (unaffected ears) may partly share the same mechanism like Group A (affected ears), namely aging and hydropic effects.

Conclusion and significance: Evolution of MD may progress from unilateral MD (MD 1.0), via unilateral MD coupled with asymptomatic hydrops on opposite ear (MD 1.5), toward bilateral MD (MD 2.0), where the number 1.0-2.0 means the number of clinically affected ears.

Chinese abstract

背景：老年梅尼埃病（MD）患者最终会失去前庭功能。

目的：本研究利用内耳测试电池来探讨MD的演变。

方法：将278名年龄大于 65岁的MD患者分为3组。将94例双侧MD（188耳）患者分到A组。其余184例单侧MD患者进一步分为两组。 B组由20只受影响的耳朵组成, 对侧耳朵具有正常的前庭功能, 而C组则由184只未受影响的耳朵组成。所有患者均接受内耳测试电池。

结果：B组内耳缺陷从耳蜗经球囊、囊体到半规管一路减轻。相反, A组和C组在颈前庭诱发肌源性潜能（cVEMP）、眼VEMP和热量测试的异常率方面没有显著差异, 表明C组（未受影响的耳朵）可能部分地具有与A组（受影响的耳朵）相同的机制, 即衰老和积水效应。

结论和意义：MD的变化可能从单侧MD（MD 1.0）, 单侧MD加对侧耳无症状水肿（MD 1.5）, 发展成双侧MD（MD 2.0）, 其中数字1.0-2.0代表临床受影响的耳朵数。

Keywords:

• Aging effect
• asymptomatic hydrops
• cervical vestibular-evoked myogenic potential (cVEMP)
• ocular vestibular-evoked myogenic potential (oVEMP)
• Meniere’s disease
• the elderly

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by the National Science Council, Taiwan (Grant no. Most 105-2314-B-002-163-MY3).