Specifically, OAEs provide information related to the function of the outer hair cells (OHC) [The use of OAEs in the assessment of patients with Meniere’s disease has been well documented. In 1972, a diagnostic criterion for Meniere’s disease was proposed by American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and till date, it has been revised twice in the years 1985 and 1995. At the same time the other (mainly neurological) causes of these symptoms can be positively ruled out. Some people will have single attacks of dizziness separated by long periods of time. If middle ear pressure is equalising well under normal circumstances, then it will be at atmospheric level, the same pressure as the pressure around us. The scan looks for the presence of some of these illnesses. During the initial stages of the disease, if the PTA is performed after an episode has subsided, the audiogram may look to be normal. These tests work out how well the eyes are wired into the brain and how well the nerve responds controlling the eyes. This is one of the positive aspects of VEMPs and why they are likely to become more prominent. Normal balance is a coordination between the body’s balance system, eyes (how the body is moving in space relevant to its surroundings) and joints (where the body is in space). If SISI score is above 70%, it is considered as positive SISI and pathology lies in the cochlea. Ménière’s disease is named after the French doctor, Prosper Ménière, who first identified it in 1861 by relating the dizziness and vertigo it causes with the inner ear, debunking the widely accepted theory that they were due to a form of cerebral apoplexy or epilepsy. It involves stimulating the canal and recording the eye movements (nystagmus) produced and is the test used by most hospital departments. In recent years VEMPs have been receiving increasing attention. It is highly useful to have previous audiograms and compare them with the current audiogram. The test is then repeated with the head turned the other way. As the patient continues to experience more and more attacks, some degree of hearing loss tends to persist in between the attacks. During initial investigation it is important to exclude many serious conditions which can cause vertigo or unilateral hearing loss and tinnitus. It goes through some neurological pathways and manifests itself as a muscle response that is measured either at the neck or around the eyes. The patient is then asked to follow the dot with their eyes as it rocks back and forth like a pendulum. PTA test is performed before the administration of glycerol and then patient is administered a solution of 86% of glycerol (1.5 mg/kg of body weight) dissolved in equal volume of physiological saline.Pure tone audiometry is then repeated at 1, 2 and 3 hours of glycerol administration.When the hearing threshold is lowered at least 15 dB at minimum three frequencies orWhen there is a total pure tone threshold shift of 25 dB at three consecutive frequencies orWhen there is a 16% improvement in speech discrimination [In the study conducted at our department (whose results have yet to be published), only those patients were included who had definite Meniere’s disease based on the AAO-HNS criteria. The patient feels a pressure change and usually a varying noise. To diagnose Ménière’s disease it is necessary to exclude many other possible causes during the consultation and investigations at the hospital. O-VEMPs are measured by electrodes placed just below the eye. The hearing test does not explain how well everyday sounds are heard but tests response to the quietest sounds which may be heard in a totally artificial scenario. Although mid- and high-frequency sensitivity tends to be good in the early stages, as the disease progresses, these frequencies become involved, leaving the patient with a “flat” audiometric configuration. After visiting their GP most people with severe vertigo are referred to their hospital’s audiology, ear nose and throat (ENT) or neurology department for investigation, diagnosis and management of their condition.
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