Diaphoresis and Meniere's disease.

The effect of diaphoresis on patients with Meniere's disease (labyrinthine hydrops) previously has not been reported. With the use of two distinct activities to produce diaphoresis, we were able to document substantial transient improvements in pure-tone threshold, speech-reception threshold, and speech discrimination concurrent with a decrease in tinnitus and fullness in two patients with unilateral Meniere's disease that had been diagnosed previously by the glycerin test. The two diaphoretic activities were (1) strenuous exercise, including periodic visits to the sauna, and (2) passive activity consisting of repetitive visits to the sauna. Glycerin, an osmotic diuretic, produces similar temporary beneficial effects primarily in patients in the fluctuant hearing stage of Meniere's disease. The glycerin test is being used in several clinics as an adjunct for the diagnosis of endolymphatic hydrops.

Static compliance of the eardrum in Meniere disease.

A recent study compared the acoustic impedance values in the affected and unaffected ears of patients with unilateral Meniere disease, and suggested that the higher impedance measured in the affected ears was due to increased intralabyrinthine pressure (endolymphatic hydrops). The present study does not support these findings. This conclusion is based on the static compliance of 17 patients with unilateral Meniere disease, measured during the glycerin test. Glycerin, an osmotic diuretic, produces transient improvements in pure-tone threshold and/or speech discrimination in the affected ear only. Orally administered glycerin is thought to cause these improvements by reducing endolymphatic hydrops. We were unable to find any change in static complicance after glycerin ingestion. Also no difference between the affected and unaffected ears, either before or after glycerin, was noted.

An unusual application of a CROS hearing aid.

This paper describes the use of the CROS hearing aid principle on cases of congenital atresia. This young girl has had several operations which attempted to create a canal and tympanum, but the canal persisted in closing. A bone vibrator eyeglass hearing aid was fitted but was largely unsuccessful. Having a 50 db air-conduction loss was handicapping to this youngster, but the usual head worn hearing aid could not be fitted because of the lack of any canal, causing feedback. She refused a body type aid. The solution is this case was a CROS behind-the-ear hearing aid. She enjoys about a 25 db useful gain from this fitting.

Pre and post-glycerol special audiometric tests battery results in endolymphatic hydrops.

The glycerol test for endolymphatic hydrops was administered to 17 patients exhibiting classical symptoms of Meniere's disease. A complete battery of audiometric tests including the SISI, TTD (Rosenberg variation). ABLB, Sweep Frequency Bekesy, two tests of speech discrimination (Rush Hughes and Northwestern), and air and bone conduction thresholds were administered pre and post-glycerol ingestion in order to determine the effect of osmotic diuresis. Improvement in pure-tone sensitivity and speech discrimination scores were most often observed. Among the special audiometric tests only the SISI scores exhibited changes, however, these could be related to the threshold changes. There were no significant differences observed in the threshold tone decay tests nor in the ABLB. The sweep frequency Bekesy test revealed only the changes which were observed in pure-tone sensitivity.