The immediate effects of acetazolamide in Menière's disease

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Abstract
The immediate effects of i.v. acetazolamide, at doses > 5 mg/kg on the subjective audiometric thresholds and transtympanic electrocochleogram [ECochG] were evaluated in 30 patients with Meniere''s disease and in 10 patients with other aural pathology. All except one of the groups who exhibited ECochG alterations gave a history of fluctuating deafness, while the magnitude of the changes tended to be directly preportional to the size of the preinfusion enhanced negative standing potential. Both these features are generally considered to be consistent with endolymphatic hydrops. In a parallel study, significant changes in the maximum conductance of patients with Meniere''s disease were noted following acetazolamide administration, which strongly suggests that this drug causes fluid changes in the cochlea. Evidently, i.v. acetazolamide induces a transient increase in the endolymphatic hydrops of certain patients with Meniere''s disease. These temporary auditory effects induced by acetazolamide may prove as reliable a diagnostic and prognostic test as glycerol dehydration.