Metabolic investigations in Menière's disease

The aetiology of Menière's disease is unknown but in recent years many theories have been advanced to explain the observed pathological changes. These include abnormal metabolic states, allergy and personality type. In an attempt to throw more light on this and to confirm or refute the earlier work we studied twenty-seven (fifteen male:twelve female) patients with Menière's disease who conformed to the criteria set out by the Committee of Hearing and Equilibration of the American Academy of Ophthalmology and Otolaryngology (Alford, 1972). In this series the incidence of abnormal metabolic states was no higher than that of a comparable group in the general population. There was no significant difference in response to pin prick skin tests compared with a control group. Klockhoff and Lindblom's (1966) glycerol dehydration test was applied to twenty-one patients. The response to this test was measured by changes in the osmolality of the serum, the pure tone threshold of hearing and the maximum speech discrimination score. Continuous transtympanic electrocochleographic recordings during glycerol dehydration were carried out and in 10 patients there was a definite decrease in the negative summating potential. An electrophysiological explanation for this has been put forward and the possible use of this measurement in the diagnosis and management of Menière's disease has been discussed. The intercorrelation between these measures and their predictive value will become apparent in the future.