From the 1st of May 2024, we offer a specialised test battery in addition to our standard assessment if Menière’s disease is suspected. This includes:
- caloric testing to assess for hypofunction in the symptomatic ear
- extra-tympanic electrocochleography to assess for increased endolymphatic pressure in the symptomatic ear
- repeat audiometry (if required) to document any fluctuations in hearing
Caloric Testing
Research shows that caloric testing is a valuable tool when it comes to aiding in the diagnosis of Ménière’s disease. Both caloric testing and the video head impulse test (vHIT) assess the function of the horizontal semicircular canals however they provide complementary information. Specifically, asymmetric caloric function in the presence of a normal vHIT is most commonly associated with Ménière’s disease and may function as a diagnostic marker.
Ménière’s disease is an inner ear disorder characterised by tinnitus, vertigo, and hearing loss. The exact aetiology of Ménière’s disease remains unclear however, it is thought to occur due to the accumulation of endolymphatic fluid in the cochlear and the vestibular organs.
Definite Menière’s disease is classified by the following:
- low- to mid-frequency sensorineural hearing loss
- fluctuating aural symptoms in the affected ear
- duration of vertigo episodes limited to between 20 minutes and 12 hours
If you require our specialised Ménière’s test battery, please make this known on the referral.
References:
Hannigan, I. P., Welgampola, M. S., & Watson, S. R. D. (2021). Dissociation of caloric and head impulse tests: a marker of Meniere’s disease. Journal of Neurology, 268(2), 431–439. https://doi.org/10.1007/s00415-019-09431-9
Koenen, L., & Andaloro, C. (2023). Meniere Disease. In StatPearls. StatPearls Publishing.
Molnár, A., Maihoub, S., Tamás, L., & Szirmai, Á. (2023). Comparison between caloric and video-head impulse tests in Ménière’s disease and vestibular neuritis. International Journal of Audiology, 62(5), 393–399. https://doi.org/10.1080/14992027.2022.2059711
Murphy, K. A., & Anilkumar, A. C. (2023). Caloric Testing. In StatPearls. StatPearls Publishing.
Lopez-Escamez, J. A., Carey, J., Chung, W. H., Goebel, J. A., Magnusson, M., Mandalà, M., Newman-Toker, D. E., Strupp, M., Suzuki, M., Trabalzini, F., & Bisdorff, A. (2017). M. Menière: Diagnostische Kriterien des Internationalen Klassifikationskomitees der Bárány-Gesellschaft [Diagnostic criteria for Menière’s disease according to the Classification Committee of the Bárány Society]. HNO, 65(11), 887–893. https://doi.org/10.1007/s00106-017-0387-z
Oliveira, L. N. R., Oliveira, C. L. A., Lopes, K. C., & Ganança, F. F. (2021). Diagnostic assessment of patients with Meniere’s disease through caloric testing and the video-head-impulse test. Brazilian Journal of Otorhinolaryngology, 87(4), 428–433. https://doi.org/10.1016/j.bjorl.2019.10.008
Pappas, D. G., Jr, Pappas, D. G., Sr, Carmichael, L., Hyatt, D. P., & Toohey, L. M. (2000). Extratympanic electrocochleography: diagnostic and predictive value. The American Journal of Otology, 21(1), 81–87. https://doi.org/10.1016/s0196-0709(00)80079-4
Yilmaz, M. S., Egilmez, O. K., Kara, A., Guven, M., Demir, D., & Genc Elden, S. (2021). Comparison of the results of caloric and video head impulse tests in patients with Meniere’s disease and vestibular migraine. European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery, 278(6), 1829–1834. https://doi.org/10.1007/s00405-020-06272-5