What audiometric pattern confirms Meniere disease?

Low-to-medium frequency SNHL (250-2000 Hz worst affected) on at least one occasion. Threshold >25 dB HL in affected frequencies with normal contralateral ear. Electrocochleography (ECoG) with SP/AP ratio >0.35-0.45 supports endolymphatic hydrops.

What treatments reduce vertigo attacks in Meniere disease?

Low sodium diet, diuretics (hydrochlorothiazide or acetazolamide) reduce attack frequency by 30-40%. Intratympanic gentamicin reduces vertigo in 85-90% (at cost of hearing risk). Endolymphatic sac surgery for refractory cases.

Can MRI diagnose endolymphatic hydrops?

Delayed gadolinium MRI (4h post-IV or 24h post-intratympanic Gd) can visualize endolymphatic hydrops. Sensitivity 80-85% for Meniere disease. Reserved for atypical presentations or surgical planning.

Meniere Disease Diagnostic Criteria Score (AAO-HNS)

Apply 2015 Barany Society/AAO-HNS classification for Meniere disease. Definite criteria: 2+ spontaneous vertigo attacks 20 min-12h, low-to-medium frequency SNHL, ipsilateral aural symptoms, not explained otherwise. Probable: same features without documented hearing loss.

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