Advanced Meniere's disease. A study of 356 severely disabled patients.

A selected material of 356 patients with Meniere's disease, all severely disabled by paroxysmal vertigo, was analysed. The question under study was to what extent and in what way the severe vertigo is reflected in the caloric reaction and in the level of hearing. The caloric response, expressed as differences in right/left sensitivity, was reduced in 59% and exaggerated in 1% of the patients; in the remaining 40% it was normal. The median values for pure tone audiogram, speech reception threshold and speech discrimination score were 56 dB,60 dB and 54%, respectively. The hearing deteriorated considerably in the early stage of the disease, but the hearing level stabilised with time. A parallelism between acoustic and vestibular dysfunction was demonstrated. Reduction of the pure tone threshold was accompanied by a progressive decrease in caloric response. The frequency of bilateral cases increased with lengthening duration of illness. All patients included in this investigation have since undergone operation.