LAUSR

1 | INTRODUC TION Maintaining the hearing of patients with Ménière’s disease (MD) is one of the priorities of treatment. MD is clinically characterised by recurrent attacks of vertigo, tinnitus, fluctuating hearing loss and a sensation of ear fullness. Generally, hearing loss gradually worsens with repeated attacks.1 While many studies have discussed the long‐ term prognosis of hearing loss in this disorder, few have investigated short‐term hearing changes. Most patients would like to know the short‐term prognosis of hearing loss and whether their hearing may recover. Head‐shaking nystagmus (HSN), first reported by Vogel,2 is tran‐ sient nystagmus after repetitive head shaking. The head‐shaking test (HST) is an easy and quick examination to estimate the asymmetry of bilateral vestibular function in an outpatient setting. Moreover, unlike the caloric test, the HST is not influenced by the condition of the external or middle ear and can be applied to dizzy patients with otitis media, post‐surgical ears or external canal atresia. HSN is con‐ sidered to be produced by asymmetrical peripheral vestibular input and a central velocity storage mechanism,3 and HSN almost always appears in a monophasic pattern, with biphasic HSN occurring only rarely.4 Researchers have reported that when HSN is provoked in patients with peripheral vestibular disorders, first‐phase nystagmus beats towards the normal ear (contralesional HSN [c‐HSN]) in most cases, but principally towards the impaired ear (ipsilesional HSN [i‐ HSN]) in patients with MD or vestibular impairment on the way to recovery.4 Kamei et al5 reported that i‐HSN during the recuperation period of MD may be an impending sign of a vertigo attack occurring within a few days. Furthermore, Junicho et al6 reported that elect‐ ronystagmography (ENG) revealed vestibular dysfunction in approx‐ imately half of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) progressing to MD, even in those who had not noticed vertigo. According to these studies, MD has various conditions of vestibular function in each stage of the illness, and HSN may reflect their reversibility. In ISSNHL, the presence of both vertigo7 and nys‐ tagmus8 can predict poor prognosis of hearing outcome. We exam‐ ined HSN in cases of MD, which varied at different times according to the condition of the disease, and which may contribute to hearing prognosis. HSN is detected more frequently than spontaneous nys‐ tagmus if there is asymmetry of bilateral vestibular function. In the present study, we performed HST and serial audiometry in MD patients to determine whether we could predict the short‐term prognosis of hearing impairment (reversible or irreversible) in MD using HST.