Qing Zhang

This narrative review focuses on the epidemiologic, clinical, and molecular aspects of Meniere disease, comparing studies from European and East Asian populations. Meniere disease is a complex, heterogeneous, chronic disorder of the human inner ear characterized by recurrent episodes of spontaneous vertigo, fluctuating sensorineural hearing loss, tinnitus, and aural fullness.The overall prevalence of Meniere disease is generally between 0.05% and 0.2% among adults worldwide. In Europe and North America, the reported point prevalence is generally higher than in East Asia, at ∼50–200 per 100,000 adults, with a female-to-male ratio of around 1.5–2:1. This contrasts with a slightly higher Meniere disease female-to-male ratio in East Asian populations, based on Korean data (∼2.17:1). Epidemiological data and genetic studies from China and other East Asian countries remain limited, with a reportedly lower incidence of Meniere disease in Japan (∼17 per 100,000/year based on national hospital surveys). In terms of clinical aspects of Meniere disease, the core symptom spectrum does not differ substantially between European and East Asian patients. Interestingly, comorbidity patterns appear to differ, whereby European studies in Meniere disease report an association with migraine and autoimmunity, whereas in East Asian data, this association is less frequently observed. Conversely, allergies and systemic inflammatory responses mediated by Th2 or autoinflammation have been reported in both European and East Asian studies. Familial Meniere disease is more commonly observed in European than East Asian populations, suggesting that the genetic structure may contribute to its susceptibility. We summarize the commonalities and differences with respect to the clinical manifestations and treatment of Meniere disease. We propose that multinational research on the molecular diagnosis and treatment of Meniere disease will facilitate a better understanding of the condition and provide impetus for future research.

Objectives: This study aims to quantitatively analyze vestibulo‐ocular reflex (VOR) gain and saccade characteristics during video head impulse testing (vHIT) in patients with vestibular migraine (VM), providing evidence for clinical diagnosis. Methods: This study included 30 definite VM patients (60 ears) and 30 healthy controls (60 ears). The function of six semicircular canals (SCCs) was evaluated by vHIT. Quantitative parameters of VOR gain and saccades were compared between groups. Benjamini–Hochberg correction was applied ( q < 0.05 considered significant). Results: No significant differences in VOR gains for all SCCs were found between groups ( q > 0.05). However, in the analysis of saccade parameters, the VM group showed higher peak velocity (q = 0.03) and shorter latency ( q = 0.03). No group differences were observed in saccade duration or frequency for lateral SCCs, nor in any saccade parameters for vertical SCCs. ROC analysis identified optimal cutoffs for the first lateral SCC saccade: peak velocity of 83.69°/s (AUC: 0.668, sensitivity: 0.586, specificity: 0.8) and latency of 295.45 ms (AUC: 0.666, sensitivity: 0.69, specificity: 0.582). Conclusion: Although VOR gains in VM patients fall within the normal range, they exhibit pathological microsaccades that differ from those of healthy individuals, characterized by lateral SCC saccades with “high velocity and short latency.” These quantitative saccade parameters hold promise as supplementary objective indicators to complement traditional VOR gain, offering auxiliary evidence for the clinical diagnosis of VM. Level of Evidence: 2.

Triple Semicircular Canal Occlusion (TSCO) has been developed in recent years as a surgical method for treating Meniere's disease(MD). To explore the effectiveness of TSCO surgery in the treatment of patients with Tumarkin crisis associated with MD. Clinical data of 7 patients with Tumarkin crisis secondary to unilateral MD were analyzed. All 7 patients with Tumarkin crisis were treated with TSCO surgery. Audiological and vestibular function assessment was performed. None of the 7 patients in the Tumarkin group experienced drop attacks after TSCO surgery. Regarding vertigo control, 6 out of 7 patients (85.7%) achieved grade A improvement while 1 patient (14.3%) achieved grade B. No statistically significant differences were found in disease duration, pure tone average, ACS-cVEMP, or ACS-oVEMP between the two groups (all p > 0.05). However, vHIT gain values in both the lateral and posterior semicircular canals were significantly higher in the Tumarkin group than in the control group (p = 0.03 and p = 0.01, respectively), but not in the superior semicircular canal (p = 0.29). TSCO surgery can probably serve as an alternative treatment for patients with Tumarkin crisis associated with MD before labyrinthectomy or vestibular neurectomy.

Vestibular dysfunction is prevalent in severe/profound unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and may influence hearing recovery. This study investigates associations between vestibular function (cVEMP/oVEMP, vHIT, caloric tests) and short-term auditory outcomes. To evaluate whether vestibular test abnormalities predict treatment response in severe/profound ISSNHL and identify independent prognostic factors. Retrospective analysis of 133 patients (mean age 53.58 ± 18.56 years) treated with steroids/hyperbaric oxygen. Vestibular tests (cVEMP, oVEMP, vHIT, caloric) were performed pre-treatment. Outcomes were categorized as effective (complete/marked recovery) or ineffective (mild/no recovery). The ineffective group had higher vertigo prevalence (65/93 vs 14/40, p < 0.001) and older age (55.98 ± 17.85 vs 48.00 ± 19.22 years, p = 0.022). Univariate analysis showed abnormal vestibular tests (oVEMP/cVEMP/vHIT/caloric) correlated with outcomes (p < 0.05). Multivariate analysis identified three independent predictors of poor outcome: vertigo (OR 0.367), abnormal caloric test (OR 0.339), and abnormal vHIT (OR 0.316). cVEMP/oVEMP abnormalities were not independently associated (p > 0.05). Vertigo, abnormal caloric/vHIT results predict poorer short-term hearing recovery in severe/profound ISSNHL. Vestibular assessment aids prognosis but should not be used alone. Larger studies are needed for validation.

Objectives: Patients with severe to profound sudden sensorineural hearing loss (SSNHL) generally experience poorer hearing recovery; however, the associated risk factors have not been identified. This study synthesizes current evidence to explore prognostic risk factors in this patient group. Methods: Databases were systematically searched through PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 18 October 2025. Three researchers independently extracted and recorded patient information and relevant data from all selected studies. Any inconsistencies were clarified through discussion or by consulting a fourth researcher. Results: The study included 2632 patients from 15 articles published between 2002 and 2025 and evaluated 8 prognostic risk factors. The results showed that profound hearing loss (OR = 4.68; 95% CI: 3.57–6.13; p < 0.001) and vertigo (OR = 1.95; 95% CI: 1.28–2.98; p = 0.002) were correlated with poorer hearing recovery. Subgroup analyses based on different prognostic criteria confirmed the consistent impact of hearing loss severity on poor outcomes. The remaining 6 risk factors did not show statistically meaningful associations. Conclusions: Profound hearing loss and vertigo are significantly associated with poorer prognosis in patients with severe to profound SSNHL. These findings may help identify high-risk patients early and inform the design of personalized therapeutic approaches in clinical settings.

Objective: To analyze the long-term effects of cochlear implantation (CI) on vestibular evoked myogenic potentials (VEMPs) in children. Methods: CI surgery was performed in a unilateral ear of 31 patients in the department of otolaryngology, Second Affiliated Hospital of Xi’an Jiaotong University from 2011 to 2015. The group comprised 15 boys and 16 girls, with a mean age of 10.68±7.60 years old. All operations were performed by the same surgeon, and the round window approach was used for all. Both ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) were detected on bilateral ears before operation. These were tested again from 1 to 5 years after operation (with device ON and OFF). The ears with CI were analyzed as the study group, and the non-operated ears were used as a control. The response rate, threshold, p13 (15) and n10 (23) latencies, and amplitudes of the VEMPs were analyzed and compared between groups. Results: Before CI, the response rates of the oVEMPs and cVEMPs in the implant ear were 58.06% and 61.29%, respectively. However, within 1 to 5 years after surgery, the oVEMP response rates decreased significantly to 16.13% (device ON, P P P P <0.01). For those patients with elicited VEMPs, abnormal waveform parameters could be found in both the oVEMP and cVEMP, including elevated thresholds, decreased amplitudes, and changed p13 (15)/n10 (23) latencies. Conclusions: Cochlear implant surgery can affect vestibular function of the implanted ear, which can be detected by the oVEMP and cVEMP tests. These effects can last for years.

Objective: The study aims to assess the high-frequency Vestibulo-Ocular Reflex (VOR) gain across three pairs of semicircular canals using the EyeSeeCam device and to determine normative values. Methods: A total of 105 volunteers, aged 19 to 69 years with no history of vestibular disorders, were enrolled. This cohort included 50 males (mean age 41.11 ± 15.98) and 55 females (mean age 35.52 ± 15.07), with no statistically significant age difference between the genders ( P = 0.078). Participants were categorized into six age brackets: 11–20, 21–30, 31–40, 41–50, 51–60, and 61–70. For each test, the recording device was consistently positioned on the left side of the goggles, and the tests were conducted by a right-handed operator. Results: The average regression gain for left anterior-right posterior canals (LARP) was 1.44 ± 0.19, significantly surpassing that of right anterior-left posterior canals (RALP) at 1.09 ± 0.13 ( p < 0.001) and horizontal semicircular canals (HSC) at 1.11 ± 0.07 ( p < 0.001). No significant difference was observed between the VOR gains of RALP and HSC ( p = 0.1077). Additionally, VOR gain values did not show significant variation across different age groups. In a gender-based analysis, a marginally higher HSC gain was observed in females (1.13 ± 0.07) compared to males (1.11 ± 0.07; p = 0.042), while no significant gender disparity was noted for RALP gains (females: 1.09 ± 0.11; males: 1.10 ± 0.14; p = 0.641). Females exhibited significantly higher LARP gain values (1.49 ± 0.18) than males (1.41 ± 0.20; p = 0.002). Conclusion: This study underscores the stability of high-frequency VOR gain values across ages. However, it also reveals a significant asymmetry in vertical canal gains (LARP vs RALP), suggesting a possible vertical canals monocular directional preponderance. This finding highlights that normative values can be highly specific to the recording and testing protocol. Thus, laboratories should develop their own normative values, customized to their equipment and testing protocols.