MEASUREMENT OF CORRELATION BETWEEN DIZZINESS HANDICAPPED INVENTORY AND PURE TONE AUDIOMETRY FOR EARLY DIAGNOSIS OF MENIERES DISEASE

Background: Menieres Disease (MD) is a chronic, non-life threatening inner ear disease, with attacks of disabling vertigo, progressive hearing loss, and tinnitus as the major symptoms. All three symptoms, separately or in combination, cause great distress and have a considerable impact on the quality of life of the patients. Objective: Aim of this study was to find out whether subjective assessment or objective assessment will be significant towards diagnosis of early Menieres disease and to find out early diagnosis of Menieres disease by comparision between Dizziness Handicapped Inventory (DHI) & Pure tone audiometry. Materials and Methods: This hospital-based retrospective study was carried out at Al Ameen Medical College Hospital, Vijayapur, Karnataka, India. The study population was composed of 93 subjects referred to the audiology department of the ENT Hospital in 01 year period, between May 2021 to April 2022. All 93 subjects underwent the following diagnostic procedures: Collecting detailed clinical history, complete neuro-otological bedside examination and pure-tone audiometry. The inclusion criteria are the presence of complete symptoms compatible with MD (tinnitus, hearing loss and vertigo) associated by documented unilateral sensorineural hearing loss. The exclusion criteria are: incomplete presentation complete presentation associated to conductive, mixed or retrocochlear hearing loss complete presentation, characterized by vertigo syndromes that are not compatible for clinical features and duration for MD. Other clinical exclusion criteria are tympanic perforations, active infections, inflammatory and non-inflammatory stenosis (exostoses, osteomas). Dizziness handicapped inventory was utilized for subjective assessment of Menieres disease whereas Pure tone audiometry was utilized for objective assessment of Menieres disease. In the DHI questionnaire, the patient answered yes, sometimes or no to each question and the strength of the responses were designated with numeric values of 0, 2, and 4. The questionnaire had 25 items, such that the total score ranges from 0 to 100, with a higher score indicating a higher handicap. The relevant data was collected using a pre-tested pro-forma and after collection it was entered in Microsoft Excel to maintain the quality of data. Result:In our study, Forty-five (48.4%) patients were male, 48 (51.6%) were female and the mean age was 48.9±12.1 years. The mean duration of MD was 5.6±4.7 (min: 10 months max: 14 years) years.The means of 0.5-2 kHz air conduction thresholds (dB HL) for unilateral MD in Pathological ear and Healthy ear were 46.8±21.4 and 15.6±13.9, respectively. Speech discrimination scores (%) for unilateral MD in Pathological ear and Healthy ear were 71.5±23.6 and 93.7±6.3, respectively. The mean scores for Physical subscore, Emotional subscore and Functional subscore as per Dizziness Handicap Inventory among the study population was 15.93±8.91, 7.3±4.78 and 16.62±8.85, respectively. The total mean score for all 25 items of DHI was 38.8±19.5. Conclusion: In our study, There was a significant relationship between pure tone audiometry and DHI for some variables. As a part of a clinical follow-up tool for patients with MD, the DHI is a valid, early and reliable health-related, disease-specific QoL scale.