Cluster analysis of auditory and vestibular test results in definite Menière's disease.

Abstract

To determine whether patients with Menière's disease can be grouped into distinct subtypes based on a cluster analysis of distinct disease parameters. Prospective study at a tertiary center associated with a university hospital. The study included 153 patients diagnosed with unilateral definite Menière's disease. The main variables employed were taken from auditory, vestibular, posturographic, and disability assessments. A four-cluster solution best fitted the data. Each cluster represented a distinct patient profile. Cluster 1 patients (13.1%) were the eldest, with the worst hearing bilaterally and good vestibular function but with a significant postural impact and a low level of disability. Cluster 2 patients (41.2%) were the least affected in all the parameters that were close to normal. Cluster 3 patients (34.6%) were the most affected, experiencing frequent and intense vertigo attacks, and they were visually dependent. Cluster 4 patients (11.1%) had strong asymmetric hearing between both ears and the most uncompensated vestibular deficit; they were moderately disabled. We have identified four distinct profiles of patients with definite Menière's disease that we consider as "mildly active elderly," "mildly active young," "active compensated," and "active uncompensated." We have demonstrated that only in a restricted population of patients can the American Academy of Otolaryngology-Head and Neck Surgery staging system provide analysis of subtypes of the disease.