メニエール病の聴力予後に関する検討

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  • Auditory Prognostic Findings in Meniere's Disease

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In patients with Meniere's disease, hearing has been thought to fluctuate, especially in the early stage. However, in some cases, hearing deteriorates suddenly and does not recover even in early stage. In other cases, hearing deteriorates gradally to some degree.<BR>We have attempted to establish prognostic criteria for hearing impairment. Pure-tone audiometry, the glycerol test, and electrocochleography performed in 136 patients with definite Meniere's disease were analyzed retrospectively.<BR>1) Among 73 patients with an interval of less than 3 years between the first attack of vertigo and the first audiometry, the average hearing threshold was less than 30 dB in 28 patients (38%), and 60 dB or more in 14 patients (19%). On the other hand, among 37 patients with an interval of 3 or more years 6 (16%) had had hearing thresholds less than 30 dB and 16 (43%) had average hearing thresholds of 60 dB or more. Thus patients with a longer duration of Meniere's disease generally have more severe hearing loss. We also observed that in some patients hearing deteriorated rapidly even in the early stage as Stahle reported (1976).<BR>2) In 29 patients, we could repeat pure-tone audio-metry one year after the first audiometry. Of the 19 patients with a history of less than 3 years, one patient had poorer hearing, 3 showed improvement, and in 15 there was no change in the average hearing threshold. Of the 10 patients with more than 3 years of symptoms none had improved hearing, 3 had worse hearing and in 7 there was no change.<BR>3) Of the 9 patients with a positive glycerol test with a history of less than one year, one patient had deterioration, 3 improvement, one fluctuation and 4 no change in the average hearing threshold. How-ever, in 5 patients with a negative glycerol test, 4 had worsening and one no change, no improvement and fluctuation in hearing.<BR>These clinical observations suggest that the glycerol test may provide some vital information for predicting the prognosis in hearing impairment in Meniere's disease.

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