[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.