The role of serum osmolality in Meniere’s disease with acute sensorineural hearing loss

Abstract

Objective

This study investigated the role of serum osmolality in Meniere’s disease (MD) patients with acute sensorineural hearing loss (SNHL).

Design

Retrospective study.

Study samples

Twenty definite MD patients with acute unilateral SNHL were treated with an osmotic diuretic (Isosorbide, 100 mL daily) and assigned to Group A. Another 20 age- and sex-matched definite MD patients with acute SNHL were not given Isosorbide and assigned to Group B. Both groups underwent audiometry and blood examination for serum osmolality before and after treatment.

Results

Group A revealed a significant increase in serum osmolality after treatment. The optimal cut-off values for increased serum osmolality in Group A were +1.5 mOSM/L for predicting hearing improvement at frequencies of 250–1000 Hz, and +2.5 mOSM/L at 2000–4000 Hz. Comparing increased levels of serum osmolality (> +2.0 vs. ≤ +2.0 mOSM/L), Isosorbide dosing at 3.0 L vs. 1.0 L, significantly differed in the odds ratio (OR). Isosorbide at a total dosage of 3.0 L thus improves the hearing threshold by >10 dB at frequencies of 250–2000 Hz.

Conclusion

The Isosorbide at a total dosage of 3.0 L may increase serum osmolality by > +2.0 mOSM/L, and improve the hearing threshold for hydropic ears at least >10 dB at low- and mid-frequencies.

Keywords:

• Osmotic diuresis
• osmolality
• endolymphatic hydrops
• Meniere’s disease

Disclosure statement

No conflict of interest declared.

Additional information

Funding

This work was funded by the National Science Council, Taiwan [MOST 110-2314-B-002-005].