The metabolic evaluation in Meniere's disease.

Meniere's disease remains today a poorly understood and difficult-to-manage inner ear problem. Numerous articles have been written about the medical and surgical management of Meniere's disease. Previous authors have suggested that a metabolic abnormality may be a contributing etiologic factor in the disease. Since 1976, 384 patients with Meniere's disease were seen in the Department of Otolaryngology and Communicative Disorders of the Cleveland Clinic Foundation. In 180 of these patients, the results of a metabolic evaluation were reviewed, including the five-hour glucose tolerance test, lipid profile, free thyroxine index, and the fluorescent treponemal antibody absorption test (FTA-ABS). The results of these tests suggest that thyroid abnormalities are rare in Meniere's disease. There may be a fairly high false-positive rate in using the FTA-ABS as a screening procedure. Carbohydrate abnormalities are found; however, hypoglycemia was not a major factor in this series of patients. A significant number of patients were found to have lipid abnormalities, and dietary management of these is believed helpful in the medical management of a patient with Meniere's disease.