Cross-Sectional Analysis of Meniere’s Disease: Comparing the American Academy of Otolaryngology- Head and Neck Surgery Diagnostic Criteria with Vestibular Staging

Lapphawat Saelee; Pornthep  Kasemsiri; Nichtima  Chayaopas; Panida  Thanawirattananit; Kwanchanok  Yimtae

doi:10.18502/avr.v34i4.19956

Lapphawat Saelee Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Pornthep Kasemsiri Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Nichtima Chayaopas Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Panida Thanawirattananit Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Kwanchanok Yimtae Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

DOI: https://doi.org/10.18502/avr.v34i4.19956

Keywords: Meniere’s disease; vestibular test; vertigo; hearing loss; inner ear

Abstract

Background and Aim: This study compared the American Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS) criteria for Meniere’s Disease (MD) with vestibular staging methods that address inner ear progression, a consideration not found in the AAO- HNS criteria.

Methods: A cross-sectional study recruited patients with MD, aged 18 to 60, from June 8, 2022, to March 20, 2023; however, we excluded patients with problems such as difficulty rolling their eyes, difficulty turning their head, conductive or mixed hearing loss, cental nerves system disorders, retrocochlear lesions, pregnancy, and receiving psychotropic drugs. Furthermore, patients with a history of labyrinthitis, vestibular migraine, stroke, benign positional vertigo, or bilateral vestibulopathy within the past 6 months were excluded. All patients were tested with audiometry, vestibular evoked myogenic potential, caloric test, and video head impulse test. Two neuro-otologists assessed and classified patients with MD according to the AAO-HNS (1990 and 2020) criteria.

Results: Forty-two patients were enrolled. The correlation between vestibular staging and both AAO-HNS (1990 and 2020) criteria was medium (p=0.02 and p<0.01, respectively). According to AAO-HNS 1995, 69% of definite MD cases were classified as stage C, whereas all probable MD cases and 30% of possible MD cases were categorized as stage B. Regarding AAO-HNS 2020, 70% of definite MD cases were classified as stage C, whereas 33.3% of probable MD cases were classified as stage B.

Conclusion: Definite MD could predict pathology in the cochleo-sacculo-utricular and lateral canals (stage C), whereas probable MD could suggest that the lesion involved the cochleo-sacculo-utricular canal (stage B).

Trial registration: This trial was registered at Thai Clinical Trials Registry on June 6, 2022 (TCTR20220606003).