Change of the Pure Tone Threshold as a Function of Frequency and Clinical Characteristics in Definite Meniere's Disease

Choi, Ki Yong; Kim, Hong Geun; Kim, Kun Woo; Lee, Min Young; Jung, Jae Yun

Abstract

BACKGROUND AND OBJECTIVES
One of the characteristics of Meniere's disease is pure tone threshold shift at low frequencies in the lesion; although, in some patients, more pure tone threshold shifts were also shown at mid or high frequencies. Authors speculated that the most varied pure tone frequency may be related with diversity of clinical symptoms and other characteristics.
SUBJECTS AND METHOD
We reviewed medical records of 85 patients who met the criteria of definite Meniere's disease (1995 American Academy of Otolaryngology-Head and Neck Surgery). Patients were classified into 3 groups (high frequency, mid frequency, low frequency) depending on the frequency at which pure tone threshold changes encountered the most. The vestibular function tests and clinical characteristics were compared between the groups.
RESULTS
Thirty-six patients (42.0%) showed pure tone threshold changes at 0.25 or 0.5 kHz (low frequency group). Twenty-five patients (30.0%) showed greatest pure tone threshold change at 1 or 2 kHz (mid frequency group). Twenty-four patients (28.0%) belonged to the high frequency group with most changes taking place not lower than 4 kHz. Frequency of vertigo attack, and duration of vertigo attack did not differ between the groups. Low frequency group showed more chance of tinnitus with statistical significance. Vestibular evoked myogenic potentials (VEMP) abnormality was more frequently encountered in the low frequency group.
CONCLUSION
This study shows that changes in the pure tone threshold is not confined to low frequencies in definite Meniere's disease. Patients with pure tone threshold changes at low frequencies have more chance of tinnitus and abnormal cVEMP.