Defining an instrumental profile of Meniere's Disease

Menière’s Disease is an idiopathic inner ear disorder characterized by spinning dizziness (lasting from 20’ to 24h), fluctuating hearing loss, ear fullness and tinnitus; all these manifestations usually occur by crisis. The natural history of the disease is characterized by variable periods of exacerbation and remission of symptoms. By definition, no acute complaints are reported by the patient during the inter-critic phases of Menière’s Disease. Relevant differences between Menière’s Disease patients often occur, particularly regarding the natural history of the vertigo and its correlation with hearing damage: the tendency is to have, as the disease progresses, an increased hearing loss (initially affecting the low frequencies) and a decreased amount and severity of the vertigo attacks. To date, there are no specific instrumental features able to clearly identify Menière’s Disease; the only validated criteria are only based on clinical aspects and sometimes can lead to misdiagnoses. Although several studies have shown the effectiveness of conservative therapy (both medical and surgical), only the ablative therapy proved to assure a good control on the vertigo spells. In particular, literature demonstrates the efficacy of intra-tympanic gentamicin, a vestibulo-toxic drug that can be administered only when the diagnosis is certain. Therefore, a complete assessment of the peripheral vestibular function is often mandatory, in order to precisely define the diagnosis, provide a staging of the disease, and plan any kind of therapy. At the same time it provides useful information about the prognosis. This research project analyzed the clinical data of more than one hundred patients affected by Menière’s Disease, with the aim to instrumentally characterize the disorder. A multivariate statistical model has allowed us to identify possible hallmarks of the disease and to determine their weight in defining an instrumental diagnosis. Our results may represent the basis for the proposal of new guidelines for an instrumentally-based diagnosis of Menière’s Disease.