What audiometric pattern is typical in Menière disease?

• A. Fluctuating low-frequency sensorineural hearing loss.
• B. Stable high-frequency conductive loss.
• C. Normal hearing.
• D. Cochlear conductive loss.

Answer: (A)

The typical audiometric pattern in Menière disease is fluctuating low-frequency sensorineural hearing loss. Endolymphatic hydrops expands the scala media in the cochlea and initially hits the hair cells at the apical (low-frequency) region, so thresholds drop most at the low frequencies. Because the hydrops can wax and wane, the hearing loss comes and goes, leading to a fluctuating pattern on repeated testing. The loss is sensorineural, meaning both air and bone conduction are affected by inner ear dysfunction, not a middle-ear problem, so there isn’t a conductive gap.

This differs from a stable high-frequency conductive loss (which points to middle-ear issues), from normal hearing (which isn’t typical once the disease manifests), and from cochlear conductive loss (not a standard description for Menière’s).