Inhalant allergy and Meniere's disease: Use of electrocochleography and intranasal allergen challenge as investigational tools

INTRODUCTION., In an earlier study, we demonstrated the feasibility of usin g electrocochleography (ECoG) to document changes in inner ear function obj ectively after intranasal challenge of patients with inhalant allergy (with no prior immunotherapy) and Meniere's disease, using the antigen to which they were most sensitive. OBJECTIVE: We expand on this earlier study and continue to investigate the feasibility of this model in a subset of patients with inhalant allergy and Meniere's disease after immunotherapy. STUDY DESIGN: Prospective study of I I patients identified with both Menier e's disease and inhalant allergy in the practices of 2 neurotologists at ou r institution. Patients underwent a baseline ECoG, followed by intranasal c hallenge with the allergen to which they were most sensitive. This was foll owed by a second ECoG. RESULTS: Six of I I patients had at least I year of immunotherapy (group 1) , and 5 of I I had had 0 to 6 months of immunotherapy (group 2). Four of 6 group I patients had a > 15% increase in SP/AP ratio after immunotherapy. I n group 2, 2 patients increased the SP/AP in at least I ear. No patient wit h a normal ECoG experienced vestibular symptoms after allergen challenge, w hereas 2 of group I and 2 of group 2 had vestibular symptoms with,abnormal ECoGs. CONCLUSION: This protocol is a useful tool for investigating the relationsh ip of inhalant allergy and Meniere's disease, but needs a larger group of p atients and further study to draw valid statistical conclusions.