Speech Perception in Ménière Disease

Fernandes, Patricia Craveiro; Takegawa, Bruno; Ganança, Fernando Freitas; Gil, Daniela

doi:10.1055/s-0043-1767677

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Brasil

International Archives of Otorhinolaryngology

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Sumário

Original Research • iao 27 (4) • June 2023 • https://doi.org/10.1055/s-0043-1767677 copy

Speech Perception in Ménière Disease

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Ménière disease (MD) affects the inner ear, comprising the cochlea and semicircular canals. Symptoms include severe incapacitating vertigo, nausea, vomit, aural fullness, and sensorineural hearing loss – in which speech discrimination and intelligibility are impaired and can be quantified with speech audiometry.

Objective

To investigate the influence of the stimuli presentation level in speech audiometry and the quality of life in adults with and without a diagnosis of MD.

Method

Two groups were formed with nine individuals each – one with and the other without MD. The Speech Recognition Percentage Index was researched with stimuli presented above the self-reported comfort level or 5 dB below the discomfort level. Dizziness Handicap and Tinnitus Handicap Inventories were administered to individuals with tinnitus and vertigo complaints.

Results

Speech recognition was better in the study group with higher presentation levels, as 75% of the sample improved their performance. The presence of vertigo significantly impacted the quality of life of individuals in the study group.

Conclusion

Speech recognition improves with higher presentation levels. Also, MD impacts the quality of life, especially regarding limitations caused by vertigo.

Keywords
meniere’s disease; tinnitus; vertigo; hearing; speech discrimination tests

Variable	Categories		Group					p-value
		Control		Study		Total
		n	%	n	%	n	%
Tinnitus	No	4	44.44	0	0.00	4	22.22	0.041*
Tinnitus	Yes	5	55.56	9	100	14	77.78	0.041*
Aural Fullness	No	9	100.00	0	0.00	9	50.00	< 0.001*
Aural Fullness	Yes	0	0.00	9	100	9	50.00	< 0.001*
Vertigo	No	8	88.89	0	0.00	8	44.44	< 0.001*
Vertigo	Yes	1	11.11	9	100	10	55.56	< 0.001*

Variable	Group	n	Mean	SD	Median	Min.	Max.
WRS – RE – Test	CG	9	94.67 [93.78–95.56]	2.00	96.00 [96.00–96.00]	92.00	96.00
WRS – RE – Test	SG	9	79.56 [67.56–89.78]	16.55	88.00 [88.00–88.00]	48.00	92.00
WRS – RE – Retest	CG	9	99.11 [98.22–100]	1.76	100 [100–100]	96.00	100
WRS – RE – Retest	SG	9	83.56 [72.08–93.78]	16.79	92.00 [72.00–96.00]	56.00	100
WRS – LE – Test	CG	9	94.67 [92.89–96.44]	3.46	96.00 [96.00–96.00]	88.00	100
WRS – LE – Test	SG	8	91.00 [85.00–95.50]	7.33	92.00 [88.00–96.00]	76.00	100
WRS – LE – Retest	CG	9	98.67 [96.89–100]	2.83	100 [100–100]	92.00	100
WRS – LE – Retest	SG	8	92.50 [85.00–99.00]	10.13	96.00 [88.00–100]	72.00	100

Ear	Group	Group	Test statistics	Shapiro-Wilk p-value
Right	CG	Test – Retest	0.390	< 0.001*
Right	SG	Test – Retest	0.753	0.009*
Left	CG	Test – Retest	0.693	0.001*
Left	SG	Test – Retest	0.866	0.139

	Test		Retest		CG		SG
	CG x SG		CG x SG		Test x Retest		Test x Retest
	p-value	ES	p-value	ES	p-value	ES	p-value	ES
WRS – RE	0.001 *^b	0.780^r	0.012*^b	0.615^r	0.004*^e	0.680^r	0.172^e	0.340^r
WRS – LE	0.199^a	1.058^d	0.172^b	0.356^r	0.008*^e	0.640^r	0.549^c	0.170^d

Variable	Category		Group						P-value
		Control		Study		Total			11.76
		n	%	n	%	n	%
WRS improvement with higher presentation levels	Yes	9	100	6	75.00	15	88.24	0.206
WRS improvement with higher presentation levels	No	0	0.00	2	25.00		2	0.206

Variable	Group	n	Mean	SD	Median	Min.	Max.	p-value	ES
THI (points)	CG	9	1.89 [1.22–2.78]	1.36	1.00 [1.00–2.00]	1.00	5.00	0.055	0.471
THI (points)	SG	9	3.22 [2.44–4.00]	1.39	3.00 [2.00–4.00]	1.00	5.00	0.055	0.471
DHI (points)	CG	9	0.67 [0.22–1.11]	1.41	0.00 [0.00–0.00]	0.00	4.00	< 0.001*	0.868
DHI (points)	SG	9	36.00 [21.78–52.89]	24.49	38.00 [12.00–42.00]	8.00	82.00	< 0.001*	0.868

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[1] Address for correspondence Patricia Craveiro Fernandes, Bacharel, Departament of Phonoaudiology, Universidade Federal de São Paulo, Sao Paulo, São Paulo, Brazil (e-mail: pfernandes@unifesp.br).