Assessing the Stage of Ménière's Disease Using Vestibular Evoked Myogenic Potentials

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Abstract
THE STAGING of Ménière's disease that was proposed by the American Academy of Otolaryngology–Head and Neck Surgery in 1995 was based on the arithmetic mean of the pure-tone thresholds at 0.5, 1.0, 2.0, and 3.0 kHz using the worst audiogram during the 6-month interval before treatment.1 The stages were classified as follows: stage I, a 4-tone average of less than 26 dB; stage II, 26 to 40 dB, stage III, 41 to 70 dB, and stage IV, more than 70 dB. Clinically, fluctuating hearing loss plays a decisive role in the diagnosis of Ménière's disease, as endolymphatic hydrops occurs most often in the cochlear area.2,3 Next to the cochlea, the saccule is the second most frequent site for hydrops formation.4 However, the associated signs and symptoms of the saccular hydrops still have to be evaluated.