Evaluation of Otolithic Function in Patients with Unilateral Ménière's Disease Using Video Ocular Counter-Roll Test.

There is a need for more laboratory tests in the diagnosis of Ménière's disease (MD). The adequacy of the findings of the video ocular counter-roll reflex (OCR) test to support the diagnosis of patients with unilateral MD in the nonattack period was investigated. Hearing tests, ocular and cervical vestibular evoked myogenic potential (VEMP), Dizziness Handicap Inventory, and video OCR tests were performed on 31 patients with unilateral MD and 30 healthy controls, and the findings were compared. There were 10 males and 21 females (51.22 ± 12.76 years) in the MD group and 12 males and 18 females (46.43 ± 9.98) in the control group. The significance of the difference between groups was analyzed using the Mann-Whitney test for continuous data and the chi-squared test for categorical data. OCR degrees in the MD group were analyzed using the Wilcoxon test. A correlation matrix and intraclass correlation coefficients were also calculated to analyze the test-retest reliability of OCR degrees with the participant's head tilted at 15, 30, and 40°. In the ocular VEMP test, the N1-P1 amplitudes of both ipsilesional (p < 0.001) and contralesional ears (p = 0.015) were significantly lower in the MD group than in the control group. In the cervical VEMP test, the P1-N1 amplitudes of the ipsilesional (p < 0.001) and the contralesional sides (p = 0.006) were significantly lower in the MD group than in the control group. The OCR degrees did not show a significant difference between the MD and control groups, except for the 30th-second OCR degree of the right eye when the head was tilted 30° to the ipsilesional side (p = 0.031) and the 20th-second OCR degree of the right eye when the head was tilted 40° to the ipsilesional side (p = 0.036). The video OCR (vOCR) test did not discriminate between the pathological and nonpathological ears in patients with unilateral MD during a nonattack period. Furthermore, the vOCR results did not discriminate between the patients with unilateral MD and the healthy controls. To obtain consistent vOCR degrees a head tilt of at least 30° and a recording time of at least 40 seconds may be required.