A Narrative Review: Redefining Meniere’s Disease Diagnosis in the Era of Precision Medicine
Kata Kunci:
Meniere's Disease, Vertigo, Auditory, Diagnostic examination, Diagnostic testAbstrak
Ménière’s disease (MD) is a chronic inner ear disorder marked by recurrent vertigo, tinnitus, aural fullness, and sensorineural hearing loss. It represents 7–8% of vertigo cases in outpatient settings and often leads to significant disability. The absence of a gold standard diagnostic test remains a challenge for accurate and timely diagnosis. A narrative review was conducted in line with Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines. Literature searches were performed in PubMed, ScienceDirect, and Google Scholar using the terms (“Meniere's Disease” OR “Vertigo” OR “Auditory”) AND (“diagnostic examination” OR “diagnostic test”), limited to the last 10 years. Eligible studies were human research evaluating diagnostic methods for MD, available in full text. Nine studies met inclusion criteria: three observational cohort, four retrospective study, two prospective study, one structured review. Diagnostic methods assessed included audiometry, Vestibular Evoked Myogenic Potentials (VEMP), Electrocochleography (ECochG), Video Head Impulse Test (vHIT), and hydrops-sensitive Magnetic Resonance Imaging (MRI). Among these, MRI emerged as the most promising technique for early and reliable diagnosis. MD is a multidimensional condition involving auditory, vestibular, and neuropsychological systems. Hydrops MRI holds strong potential as a future diagnostic standard, but further multicenter validation is required before its widespread clinical adoption.
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Referensi
Alsarhan, H. (2021). Identification of early-stage Meniere’s disease as a cause of unilateral tinnitus. Journal of Otology, 16(2), 85–88.
Bächinger, D., Schuknecht, B., Dlugaiczyk, J., & Eckhard, A. H. (2021). Radiological configuration of the vestibular aqueduct predicts bilateral progression in Meniere's disease. Frontiers in Neurology, 12, 674170. https://doi.org/10.3389/fneur.2021.674170
Balcı, B., & Akdal, G. (2020). Imbalance, motion sensitivity, anxiety and handicap in vestibular migraine and migraine only patients. Auris Nasus Larynx. https://doi.org/10.1016/j.anl.2020.02.015
Basura, G. J., Adams, M. E., Monfared, A., Schwartz, S. R., Antonelli, P. J., Burkard, R., & Buchanan, E. M. (2020). Clinical practice guideline: Ménière’s disease executive summary. Otolaryngology–Head and Neck Surgery, 162(4), 415–434. https://doi.org/10.1177/0194599820909997
Cheon, T. U., Park, J. H., Lee, J. S., & Bae, S. H. (2025). Defining diagnostic thresholds for dissociation between caloric test and vHIT in Ménière's disease. Frontiers in Neurology, 16, 1651714. https://doi.org/10.3389/fneur.2025.1651714
Couth, S., Prendergast, G., Guest, H., Munro, K. J., Moore, D. R., Plack, C. J., Ginsborg, J., & Dawes, P. (2024). A longitudinal study investigating the effects of noise exposure on behavioural, electrophysiological and self-report measures of hearing in musicians with normal audiometric thresholds. Hearing Research, 451, 109077. https://doi.org/10.1016/j.heares.2024.109077
Drabkin, S., Maniaci, A., Lentini, M., Iannella, G., Tainmont, S., Lelubre, C., & Mat, Q. (2024). Assessment of the inter-frequency amplitude ratio (1000/500 Hz) in cVEMP and oVEMP for the diagnosis of Ménière’s disease. Audiology Research, 14(6), 1126–1135. https://doi.org/10.3390/audiolres14060093
Fisch, K. M., Rosenthal, S. B., Mark, A., Sasik, R., Nasamran, C. A., Clifford, R., & Friedman, R. A. (2024). The genomic landscape of Ménière's disease: A path to endolymphatic hydrops. BMC Genomics, 25(1), 646. https://doi.org/10.1186/s12864-024-09145-0
Frejo, L., & Lopez-Escamez, J. A. (2023). Recent advances in understanding molecular bases of Ménière’s disease. Faculty Reviews, 12, 11. https://doi.org/10.12703/r/12-11
Huang, M., Wang, X., & Chen, M. (2025). Optimizing staging of Meniere's disease: Integrating electrocochleography with vestibular tests. Frontiers in Neuroscience, 19, 1600665. https://doi.org/10.3389/fnins.2025.1600665
Kim, J. S. (2020). Electrocochleography in cochlear implant users with residual acoustic hearing: A systematic review. International Journal of Environmental Research and Public Health, 17(19), 7043. https://doi.org/10.3390/ijerph17197043
Kitano, K., Kitahara, T., Ito, T., Shiozaki, T., Wada, Y., & Yamanaka, T. (2020). Results in caloric test, video head impulse test and inner ear MRI in patients with Ménière’s disease. Auris Nasus Larynx, 47, 71–78. https://doi.org/10.1016/j.anl.2019.06.002
Lamounier, P., de Souza, T. S. A., Gobbo, D. A., & Bahmad, F. Jr. (2017). Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of Ménière's disease. Brazilian Journal of Otorhinolaryngology, 83(4), 394–403. https://doi.org/10.1016/j.bjorl.2016.04.021
Lorente-Pera, J., Blanco, M., Santos-Garrido, J., Manrique-Huarte, R., Suárez-Vega, V., Domínguez, P., Fullaondo, J., Arbizu, L., & Pérez-Fernández, N. (2025). Functional audiometric dissociation in Ménière's disease: Exploring the mismatch between pure-tone thresholds and speech recognition. Journal of Clinical Medicine, 14(13), 4747. https://doi.org/10.3390/jcm14134747
Mavrodiev, V., Strupp, M., Vinck, A.-S., Van De Berg, R., & Lehner, L. (2024). The dissociation between pathological caloric testing and a normal video head impulse test helps differentiate between Ménière’s disease, vestibular migraine, and other vestibular disorders: A confirmatory study in a large cohort of 2,101 patients. Frontiers in Neurology, 15, 1449261. https://doi.org/10.3389/fneur.2024.1449261
O’Leary, S., Briggs, R., Gerard, J. M., Iseli, C., Wei, B. P. C., Tari, S., Rousset, A., & Bester, C. (2020). Intraoperative observational real-time electrocochleography as a predictor of hearing loss after cochlear implantation: 3 and 12 month outcomes. Otolaryngology–Head and Neck Surgery, 41, 1222–1229. https://doi.org/10.1177/0194599820921000
Pyykkö, I., Zou, J., & Vetkas, N. (2024). Changes in symptom pattern in Meniere's disease by duration: The need for comprehensive management. Frontiers in Neurology, 15, 1496384. https://doi.org/10.3389/fneur.2024.1496384
Riggs, W. J., Dwyer, R. T., Holder, J. T., Mattingly, A. O., Ortmann, A., Noble, J. H., Dawant, B. M., Valenzuela, C. V., O’Connell, B. P., Harris, M. M., et al. (2019). Intracochlear electrocochleography: Influence of scalar position of the cochlear implant electrode on postinsertion results. Otolaryngology–Head and Neck Surgery, 40, e503–e510. https://doi.org/10.1177/0194599819851509
Scarpa, A., Ralli, M., De Bonis, E., Troisi, D., Montanino, A., Viola, P., & Cassandro, C. (2020). Pharmacological, surgical and diagnostic innovations in Meniere’s disease: A review. Translational Medicine@ UniSa, 23, 48.
Shugyo, M., Ito, T., Shiozaki, T., Nishikawa, D., Ohyama, H., Fujita, H., et al. (2020). Comparison of the video head impulse test results with caloric test in patients with Meniere’s disease and other vestibular disorders. Acta Otolaryngologica, 140, 720–727. https://doi.org/10.1080/00016489.2020.1766700
Ueda, K., Ito, T., Inui, H., Fujita, H., Shiozaki, T., Miyasaka, T., et al. (2023). Effects of endolymphatic space volume on discrepancy of results between caloric test and video head impulse test. Auris Nasus Larynx, 50, 499–506. https://doi.org/10.1016/j.anl.2022.11.001
Xiao, H., Guo, X., Cai, H., Lin, J., Lin, C., Fang, Z., & Ye, S. (2022). Magnetic resonance imaging of endolymphatic hydrops in Ménière's disease: A comparison of the diagnostic value of multiple scoring methods. Frontiers in Neurology, 13, 967323. https://doi.org/10.3389/fneur.2022.967323
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 Ménière's disease and vestibular migraine. European Archives of Oto-Rhino-Laryngology, 278, 1829–1834. https://doi.org/10.1007/s00405-020-06272-5
Yuan, V., Xia, A., & Santa Maria, P. (2025). Immunological mechanisms in Meniere's disease. Frontiers in Immunology, 16, 1639916. https://doi.org/10.3389/fimmu.2025.1639916
