Low-frequency transient-evoked otoacoustic emission characteristics as potential indicators of hearing improvement in acute Ménière's disease: an exploratory analysis.

PURPOSE: Fluctuating hearing loss in Ménière’s disease (MD) presents a key clinical challenge due to lack of reliable prognostic markers. The clinical value of transient-evoked otoacoustic emissions (TEOAEs) low-frequency components remains underexplored due to technical difficulty in signal extraction. This study profiled the group delay (GD) and magnitude of low-frequency TEOAEs and observed the association with hearing improvement after acute MD episode. METHODS: 31 patients with unilateral MD were prospectively enrolled during the acute phase of cochleovestibular symptoms. TEOAE and pure-tone audiometry were recorded from initial clinic visit through follow-up. Spectral analysis of TEOAEs was conducted at 500, 1000, and 2000 Hz. The affected ears were categorized into “improved” or “nonimproved” group based on a pragmatic ≥ 10 dB gain in pure-tone average (PTA). The contralateral ears served as convenience controls. RESULTS: Nine (29%) of thirty-one affected ears met the criteria for hearing improvement. Our exploratory analyses showed that 500 Hz GD of the improved group was significantly longer (p < 0.026) initially but did not change longitudinally despite PTA improvement. CONCLUSION: TEOAE phase-gradient metrics (GD) at 500 Hz differ between MD patients with and without hearing improvement in our preliminary findings. Profiling low-frequency otoacoustic emission components may possibly reflect the baseline status or reversibility of OHC function related to hearing improvement after an acute episode.