Long-term Hearing Outcomes and Prognostic Factors in Patients with Meniere's Disease.

BACKGROUND

Meniere's disease (MD) presents with vertigo and fluctuating auditory symptoms, linked to endolymphatic edema. Increased antidiuretic hormone levels due to stress suggest that hydration therapy (HT) can suppress this hormone. This study examined hearing outcomes in patients with MD treated with HT and factors influencing hearing fluctuations.

METHODS

The study included 188 participants (45 men and 143 women) with definite MD who were followed for over 4 years with HT (35 mL/kg water daily). Clinical characteristics, hearing thresholds, and hematological findings were analyzed. The average hearing threshold at low frequencies (125, 250, and 500 Hz) was measured at the first examination (pre-HT) and 4 years after HT (post-HT). Factors affecting pre-HT hearing thresholds, changes between pre-HT and post-HT, and factors influencing hearing changes during HT were investigated.

RESULTS

Advanced age, male sex, disease duration, high creatinine level, low estimated glomerular filtration rate, and high white blood cell (WBC) counts correlated with poor hearing thresholds. No significant increase was observed in hearing thresholds between pre-HT and post-HT, with 70% showing stable or improved hearing after 4 years. Poor initial hearing threshold, high WBC count (P=.032), and high neutrophil count (P=.0090) were less likely to cause hearing deterioration.

CONCLUSION

Hearing remained stable for over 4 years after HT. High WBC and neutrophil counts correlated with poor prognosis due to stress-related inflammation. Dehydration, elevated WBC counts, and stress may worsen outcomes, suggesting that HT effectively manages MD by stabilizing hearing and reducing stress.