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. 2025 Jul 8:19:1600665.
doi: 10.3389/fnins.2025.1600665. eCollection 2025.

Optimizing staging of Meniere's disease: integrating electrocochleography with vestibular tests

Muchen Huang  1   2 , Xianren Wang  1   2 , Minqi Chen  3
Affiliations

Optimizing staging of Meniere's disease: integrating electrocochleography with vestibular tests

Muchen Huang et al. Front Neurosci. .

Abstract

Objectives: This study aimed to evaluate the diagnostic and staging efficacy of integrating electrocochleography (ECochG) with vestibular function tests-specifically cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP), caloric test (CT), and video head impulse test (vHIT)-for Ménière's disease (MD).

Design: Data were collected from 54 MD patients (66 affected ears) admitted to a hospital between January 2023 and January 2024. Each participant underwent pure tone audiometry, ECochG, cVEMP, oVEMP, CT, and vHIT. The results were compared against both established clinical criteria and a newly proposed staging system. Inclusion criteria followed the 2015 diagnostic guidelines for MD. Statistical analyses, including ANOVA, Chi-square, and Kruskal-Wallis H tests, were conducted, and a random forest model was employed to validate the robustness of the proposed staging system.

Results: The novel staging system, incorporating vestibular function tests, demonstrated superior sensitivity and diagnostic accuracy compared to traditional audiometry-based staging. Early-stage MD detection improved significantly, with vestibular test abnormalities strongly correlating with disease progression. The overall positive rate for any test was 98.5%. ECochG abnormalities were detected in 54.5% of cases, while cVEMP and oVEMP abnormalities were observed in 75.8% and 69.7% of cases, respectively. The new staging system exhibited a stronger correlation with vestibular dysfunction, effectively identifying functional impairment prior to significant hearing loss.

Conclusion: The integration of ECochG with vestibular function tests provides a more comprehensive diagnostic framework for MD. This multimodal approach enhances early detection, improves staging accuracy, and offers deeper insights into disease progression, thereby facilitating more personalized treatment strategies.

Keywords: Meniere’s disease; diagnostic staging; electrocochleography; inner ear dysfunction; vestibular function tests.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Dot plot displaying pure-tone thresholds in decibels hearing level (dBHL) across four stages. Stage I is blue, Stage II is red, Stage III is green, and Stage IV is purple. Data points and error bars illustrate variability and average thresholds in each stage.
FIGURE 1
The average hearing threshold distribution at each new stage. The horizontal axis represents the four stages (stage I to stage IV) of the new classification system, while the vertical axis shows the pure-tone hearing thresholds measured in decibels hearing level (dBHL). Individual data points represent measurements for each subject within the corresponding stage, with the central horizontal line indicating the mean value and the error bars representing the standard deviation (SD). This figure illustrates the variation in hearing thresholds and the progression across stages.
Bar chart comparing new stage (red) and clinical stage (green) percentages across four stages. Stage I: new 40%, clinical 10%. Stage II: new 20%, clinical 10%. Stage III: new 20%, clinical 50%. Stage IV: new 10%, clinical 20%.
FIGURE 2
Comparison of staging distribution. The figure illustrates the distribution of 66 patients across four stages (stages I–IV) using both the new and clinical staging methods. Notably, most patients in the new staging system are classified into stage I and stage II, highlighting its superior ability to facilitate early-stage diagnosis compared to the clinical staging method.
See this image and copyright information in PMC

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