[A comparative study of auditory and vestibular function in patients with acute low-tone sensorineural hearing loss versus stage 1 and 2 Ménière's disease].

Objective:This review compares acute low-tone sensorineural hearing loss（ALHL） and stage 1 and 2 Ménière's Disease（MD） in terms of their clinical presentation, audio-vestibular profiles, and pathophysiological mechanisms, aiming to elucidate key distinctions and commonalities to guide differential diagnosis and treatment. Methods:The study included 61 patients with unilateral ALHL and 41 patients with unilateral stage 1 and 2 MD. The demographic characteristics and findings from pure-tone audiometry, electrocochleography（ECochG）, spontaneous nystagmus（SN）, caloric test, vestibular evoked myogenic potentials（VEMP）, and the video head impulse（vHIT） were retrospectively analyzed. Results:①ALHL was associated with a significantly younger age of onset（t=-4.467, P<0.001） and a higher female preponderance（χ²=7.918, P=0.005） compared to the MD group. ②MD patients exhibited significantly higher mean hearing thresholds than ALHL patients（Z=-5.827, P<0.001）. While there was no significant difference in low-frequency hearing thresholds between the two groups, ALHL patients had significantly lower mean hearing thresholds at mid-frequency（F=13.901, P<0.001） and high-frequency（Z=-6.963, P<0.001）. Compared with MD patients, ALHL patients demonstrated a lower ECochG abnormality rate on the affected side（χ²=6.894, P=0.009） and a smaller summating potential/action potential ratio on the affected side（Z=-2.975, P=0.003）. ③No statistically significant difference in SN was found between ALHL and MD patients（χ²=1.051, P=0.305）. No significant differences were found between ALHL and MD patients regarding the abnormality rate of reduced caloric response on the affected side（χ²=1.943, P=0.163）. A lower canal paresis value was observed in ALHL patients compared to those with MD（F=5.345, P=0.024）. There was no significant difference in the abnormality rates of cervical VEMP（χ²=0.091, P=0.763） or ocular VEMP（χ²=1.024, P=0.312） between the groups. vHIT results were negative in all patients of both groups. Conclusion:Although both ALHL and stage 1 and 2 MD are hydropic disorders with comparable hearing loss patterns, their divergent clinical and audio-vestibular profiles point to differences in pathophysiology. Clarifying their interrelationship calls for additional long-term studies.