Diagnostic Tendency for Meniere's Disease

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Laboratorinė medicina. 2018,
t. 20,
Nr. 4,
p. 291 -
296

Objective. To review literature on the diagnosis of Meniere’s disease and evaluate the significance of temporal bone MRI in making the diagnosis.

Methods. The search for literature was done through the Pubmed database using the terms “Meniere’s Disease”, “Endolymphatic hydrops”, “Temporal bone MRI”, “Vestibular function”. Publications reviewed were from 2008-2017.

Literature review. It was the French physician Prosper Meniere who first described Meniere’s disease in 1861. Unfortunately, the causes of the disease remain to be undecipherable until now. Just an assumption stating the fact that an inner ear endolymphatic hydrops can lead towards a tetrad of symptoms, such as acute systematic dizziness, tinnitus, aural fullness and fluctuating hearing loss in the impaired ear, has been drawn. In 2015 the Barany’s International Society of Otoneurology outlined the criteria for Meniere’s disease diagnostics. Among them, the nature of the seizure, intermittent hearing impairment symptoms, and audiometric data were considered of high importance. The disease is classified into two types: possible and probable Meniere’s disease. According to the criteria, hearing impairment as the most significant indication for the diagnosis of the target disease was emphasized. Audiometry is recommended as the only objective and reliable instrumental test in diagnosing suspected cases of Meniere’s disease. Caloric tests are also widely used to evaluate vestibular disorders in the disease. Due to the rapid advancement in technology, there appears an opportunity to visualize inner ear structures with visual examination methods in vivo. New instrumental 3T temporal bone MRI test with gadolinium contrast helps to evaluate endolymphatic sac and approve the diagnosis of Meniere’s disease.

Conclusion. Upon investigation of 26 publications, the diagnosis of Meniere’s disease continues to be based only on subjective clinical criteria and not on instrumental test results. Temporal bone 3T MRI with gadolinium contrast is an objective instrumental test that aids in diagnosing Meniere’s disease.

 

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