Table_1_A New Proposal for Severity Evaluation of Menière's Disease by Using the Evidence From a Comprehensive Battery of Auditory and Vestibular Tests.XLSX

To date, no widely accepted criteria exist to quantify the severity of Menière's disease (MD) by using vestibular tests. This study aimed to compare association of hearing loss and vertigo severity with association of accurate assessments of vestibular function and the vertigo severity. The severity of vertigo was documented by a comprehensive medical history with number of vertigo attacks in the past 6 months and a Dizziness Handicap Inventory (DHI) questionnaire. The involvement of vestibular organs was verified by audio-vestibular tests in 80 definite MD patients. Correlations between DHI scores, number of vertigo attacks in the past 6 months, audio-vestibular function, and the number of involved vestibular end organs were evaluated. We show that there are no significant differences in either severity of vertigo or laboratory results across the degree of hearing loss. Furthermore, the number of involved vestibular end organs was significantly correlated with vestibulo-ocular reflex gain in anterior and posterior canal video head impulse test (vHIT), interaural asymmetry ratio in vestibular-evoked myogenic potentials (VEMPs), and number of vertigo attacks in the past 6 months and DHI score. The vestibulo-ocular reflex gain in the rotatory chair test (RCT) was significantly correlated with the DHI Physical scores and number of involved vestibular end organs at 0.08 Hz. These results indicate that hearing loss is a poor indicator of vertigo severity in MD whereas the number of involved vestibular end organs may serve as an objective measure for MD progress. A battery of vestibular tests targeting different sensor organs is a complementary method for evaluating inner ear deficits and may aid in “grading” the severity of MD.

迄今为止，尚无广泛认可的标准化准则能够通过前庭功能测试对梅尼埃病（MD）的严重程度进行量化。本研究旨在比较听力损失和眩晕严重程度与前庭功能准确评估之间的关系。眩晕的严重程度通过详尽的病史记录（包括过去6个月内眩晕发作的次数）及晕厥障碍问卷（DHI）进行评估。80例确诊为MD的患者通过音频前庭测试验证了前庭器官的受损情况。对DHI评分、过去6个月内眩晕发作次数、音频前庭功能以及受损前庭终末器官的数量之间的相关性进行了评估。研究发现，无论是在眩晕严重程度还是实验室结果方面，均未发现听力损失程度与眩晕严重程度之间存在显著差异。此外，受损前庭终末器官的数量与前庭眼动反射增益（在前后半规管视频头脉冲测试（vHIT）中）、前庭诱发肌电图（VEMPs）的耳间不对称比率以及过去6个月内眩晕发作次数和DHI评分之间存在显著相关性。旋转椅测试（RCT）中的前庭眼动反射增益与DHI生理评分和0.08 Hz时受损前庭终末器官的数量之间存在显著相关性。这些结果表明，在MD中，听力损失并非眩晕严重程度的良好指标，而受损前庭终末器官的数量可能作为MD进展的客观指标。一套针对不同感测器官的前庭测试可以作为评估内耳缺陷的补充方法，并有助于对MD的严重程度进行“分级”。