Posterior fossa meningioma constitute approximately 10% of meningiomas. It can rarely involve the endolymphatic sac and produce symptoms of Meniere's disease. We present the case of a 41-year-old male patient who was suffering from recurrent vertigo. The pure tone audiogram revealed low tone hearing loss on right side and temporal magnetic resonance image revealed a meningioma in posterior fossa. Posterior fossa meningioma should be considered in the differential diagnosis of patients with signs and symptoms of Meniere's disease.
Adult ; Diagnosis, Differential ; Endolymphatic Hydrops ; Endolymphatic Sac ; Hearing Loss ; Humans ; Magnetic Resonance Spectroscopy ; Male ; Meniere Disease ; Meningioma ; Stress, Psychological ; Vertigo

Objective:To investigate the characteristics of wideband acoustic immittance（WAI） measurements in patients with unilateral Ménière's disease（MD） and evaluate the clinical value of WAI in diagnosis of MD. Methods:WAI was performed in 30 patients with unilateral MD（30 ears for symptomatic and 30 ears for asymptomatic） and in 26 healthy individuals（52 ears）（control group）. The WAI measurements, including the frequency first appearing two peaks in energy absorbance（EA） tympanogram, resonance frequency（RF）, the peak value of absorbance（PVA）, the integral area of absorbance（IAA）, EA curve at peak pressure, were analyzed. Results:①The occurrence of two peaks in EA tympanogram in both the MD symptomatic and asymptomatic ear was observed in 27 ears（84.4%）, and 38 ears（70.4%） in the control group, with no significant difference in the frequency of first appearing in two peaks onset between the groups（all P>0.05）. ②The RF of the MD symptomatic ears was significantly lower than that of the asymptomatic ears（t=-3.544, P=0.001） and that of the control subjects（t=2.084, P=0.041）; there was no difference of RF between the MD asymptomatic ears and the control group（P>0.05）. ③The PVA were significantly lower in both MD symptomatic（t=4.240, P<0.01） and asymptomatic ears（t=4.202, P=0.001） than in controls. ④The IAA in MD symptomatic（t=3.295, P=0.001） and asymptomatic ears（t=3.193, P=0.003） was significantly lower than in the control group. ⑤Comparison of the EA curve at peak pressure of the three groups: the EAs of MD symptomatic ears were lower than those of the control group at the range of 1 059-2 911 Hz（all P<0.05）; the EAs of MD symptomatic ears were lower than those of MD asymptomatic ears within 1 000 Hz and 1 834-2 119 Hz（all P<0.05）; the EAs of MD asymptomatic ears were lower than those of the control group at the range of 515-2 748 Hz（all P<0.05）. Conclusion:Symptomatic ears in unilateral MD patients show alterations in some WAI measurements compared to asymptomatic ears and/or controls, suggesting that middle ear mechanical fuction of the affected side may be modified due to the endolymphatic hydrops. The clinical significance of WAI needs to be further explored in the context of evaluating MD.
Humans ; Meniere Disease/diagnosis* ; Endolymphatic Hydrops/diagnosis* ; Ear ; Hearing Tests ; Acoustics

Low frequency sensorineural deafness is a common subtype of idiopathic sudden deafness. Certain patients suffered recurrent attacks without vertigo, much alike Meniere's disease. Few of them developed into definite Meniere's disease during long-term follow-up in many clinical studies. Although the pathophysiology of recurrent low frequency deafness is yet unknown, the desease is considered associated with early state of endolymphatic hydrops or migraine. Otologists shall be aware of its clinical course and careful explanation is necessary at time of initial informed consent.
Endolymphatic Hydrops ; complications ; Hearing Loss, Sensorineural ; complications ; diagnosis ; Hearing Loss, Sudden ; Humans ; Meniere Disease ; complications ; Vertigo

Meniere's disease (MD), a kind of common disease of otology, is based on the endolymphatic hydrops. The clinical features of MD are intermittent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus and ear fullness. With the in-depth exploration of the disease, the diagnosis and treatment of MD has made a series of research results. In this paper, the related literature and research reports in recent years were reviewed.
Endolymphatic Hydrops ; Hearing Loss, Sensorineural ; Humans ; Meniere Disease ; diagnosis ; therapy ; Tinnitus ; Vertigo

The Best clinical approaches for Meniere's disease starts from the proper diagnosis which is based on the clinical symptoms, including the characteristic features of vertigo and auditory symptoms. After first criteria has been made in 1972 by the American Academy of Otolaryngology-Head and Neck Surgery, it has been revised two times in 1985 and 1995. Japanese criteria have been made in 1974 and revised 2008. Most recent criteria of the Barany Society has been established in 2015. The basic notion is almost similar among these criteria, but detailed descriptions has been gradually changed in characteristics of vertigo and auditory symptoms based on the updated research data and consensus. Understanding of how the diagnostic criteria of Meniere's disease has been evolved is very important in terms of good clinical practice because they contain the development of knowledge about the disease. This article reviewed all the diagnostic criteria, and compared the differences.
Asian Continental Ancestry Group ; Consensus ; Diagnosis* ; Endolymphatic Hydrops ; Humans ; Meniere Disease* ; Neck ; Vertigo

Meningiomas account for 13 to 37% of all primary brain tumors, with 15% of all intracranial meningiomas arising in the posterior fossa. Patients with jugular foramen meningiomas (JFMs) may present with vague, non-specific vertiginous symptoms and sensorineural hearing loss (SNHL). Recently, the author encountered a unique case of JFM with symptoms similar to those of Ménière's disease and those of delayed endolymphatic hydrops. The patient discussed in the present case is a 17-year-old woman with a several month history of right SNHL and recurrent attacks of vertigo. The initial diagnosis of vertigo was later diagnosed as a JFM of the clear cell subtype, which is a remarkably rare pathological finding among intracranial meningioma. This study reports a case of JFM of the clear cell subtype in addition to a review of the literature.
Adolescent ; Brain Neoplasms ; Diagnosis ; Endolymphatic Hydrops ; Female ; Hearing Loss, Sensorineural* ; Humans ; Meniere Disease ; Meningioma* ; Vertigo*

Electrocochleography(ECoG) is used to evaluate the cochlear function in patients with Meniere's disease. Endolymphatic hydrops is widely accepted as the underlying pathological finding in Meniere's disease and may cause the elevation of the ratio of summating potential amplitude to action potential amplitude. So, SP/AP amplitude ratio has been suggested as a diagnostic indicator for Meniere's disease. A variety of electrode locations have been employed to record the precise cochlear potentials better. In this study, we peformed extratympanic ECoG with an electrode(TIP trode(R)) that was placed in contact with the ear canal wall in normal subjects and Meniere's patients. The SP/AP amplitude ratio and the SP amplitude measured in the ears of patients with bilateral Meniere's disease and in the involved ear of patients with unilateral Meniere's disease were significantly larger than in the ears of normal subjects. In the contralateral ear of patients with unilateral Meniere's disease, the SP/AP amplitude ratio was significantly larger than in the ears of normal subjects; however, it was below the level for the diagnostic criteria of endolymphatic hydrops in Meniere's disease. This study suggests that ECoG can be a useful tool for the diagnosis of Meniere's disease and the early detection of incipient Meniere's disease in the contralateral ear of a patient with unilateral Meniere's disease.
Action Potentials ; Audiometry, Evoked Response* ; Diagnosis ; Ear ; Ear Canal ; Electrodes ; Endolymphatic Hydrops ; Humans ; Meniere Disease

Objective: To analyze the clinical characteristics of vestibular syncope (VS) associated with drop attacks (DA) in delayed endolymphatic hydrops (DEH). Methods: DEH cases with complete data were retrospectively analyzed, including three DEH cases with DA and VS (VS group), and six DEH cases without DA or VS (control group). The clinical profile, the results of neurotological examinations [such as pure tone audiometry, electrocochleography (EcochG), caloric test, vestibular evoked myogenic potentials (VEMP), and video head impulse test (vHIT)] and treatment outcomes were analyzed. Results: (1) In the VS group, there were three cases of ipsilateral DEH; in the control group, there were six cases of ipsilateral type. One case in each group had a history of migraine. (2) The prevalence of abnormal results in caloric test, vHIT, cervical VEMP, and ocular VEMP in the VS group was 3/3, 1/3, 2/2, and 2/2, respectively, and in the control group was 3/6, 0/3, 1/6, and 4/6, respectively. Two cases in each group underwent EcochG, and no identifiable waveform was elicited on the affected side, and-SP/AP ratio of unaffected side was less than 0.4. (3) Patients in both groups were initially treated with conservative medication. Two cases in the VS group subsequently received intratympanic injections of dexamethasone. No DA or VS occurred during a follow-up period lasting over one year. All patients achieved good control of vertigo during the follow-up period. Conclusions: VS may occur in the patients with DEH. The differential diagnosis of syncope in patients with otogenic vertiginous disease can help improve clinical diagnosis and treatment.
Endolymphatic Hydrops/diagnosis* ; Humans ; Retrospective Studies ; Syncope ; Vestibular Evoked Myogenic Potentials ; Vestibule, Labyrinth

OBJECTIVETo study the characteristic of the cochlear hydrops analysis masking procedure (CHAMP) in normal adults, and to evaluate the diagnostic values of its parameters for membranous labyrinth hydrops.

METHODSTwenty otologically normal adults were recruited (male:female = 10:10), and their auditory brainstem responses (ABR) were obtained to six stimulus conditions using Bio-logic auditory evoked potential system: clicks presented alone (unmasked condition) and clicks presented with ipsilateral pink noise high-pass filtered at 8, 4, 2, 1, and 0.5 kHz respectively.

RESULTSThe wave V latency of ABR to the high-pass masking pink noise clicks were longer than ABR to clicks alone. The latency delays of wave V for clicks presented with ipsilateral pink noise high-pass filtered at 8, 4, 2, 1, and 0.5 kHz compared to clicks alone were (0.30 ± 0.18), (0.97 ± 0.43), (1.65 ± 0.64), (3.21 ± 0.56), (4.66 ± 0.37) ms respectively. The complex amplitude ratio between ABR to click + 0.5 kHz high-pass noise and click alone was 0.95 ± 0.11.

CONCLUSIONSCHAMP is a promising diagnostic method for membranous labyrinth hydrops, and the latency delay of wave V might be used as the normal criterion. The specificity of the complex amplitude ratio need further evaluation in clinical work.

Adolescent ; Adult ; Endolymphatic Hydrops ; diagnosis ; physiopathology ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Male ; Noise ; Perceptual Masking ; Young Adult

Delayed endolymphatic hydrops （DEH） is a rare disease that causes vertigo and is often misdiagnosed as other vertigo diseases. This article reports on a patient with vertigo who was easily misdiagnosed. The patient was a middle ear cholesteatoma complicated by labyrinthine fistula （LF）; however, his vertigo was episodic vertigo, which could not be explained solely by LF causing labyrinthitis. The possibility of endolymphatic hydrops was suspected, which was confirmed by inner ear magnetic resonance gadolinium imaging. This is the first reported case of middle ear cholesteatoma complicated by LF and DEH. The patient underwent surgical resection of the cholesteatoma and three semicircular canal obstructions at the same time. During two years postoperative follow-up, the patient did not experience a recurrence of vertigo. When diagnosing vertigo diseases, a careful history of vertigo is of utmost importance.
Humans ; Endolymphatic Hydrops/diagnosis* ; Cholesteatoma, Middle Ear/complications* ; Vertigo/complications* ; Labyrinth Diseases/complications* ; Magnetic Resonance Imaging/adverse effects* ; Semicircular Canals