Systematic monitoring of Meniere’s disease: A smartphone-based approach for the periodical assessment of audiometric measures and fluctuating symptoms

Lydia Stylou1, Iordanis Thoidis2, George Papanikolaou3

1 Laboratory of Electroacoustics and TV Systems, Department of Electrical and Computer Engineering; 2 Faculty of Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece

Background: Meniere’s disease is a progressive disorder of the inner ear, characterized by spontaneous vertigo, fluctuating hearing loss and tinnitus. Pure tone audiometry is the principal tool for following up the disease progression and treatment. Unfortunately, lack of sufficient data emerges from this measurement. Therefore, it is crucial to seek for reliable self-testing methods of audiometry that overcome the barrier of audiometric device calibration. In this study, a software application for mobile devices is proposed, in an attempt to record the course of patients with Meniere’s disease or fluctuating hearing loss.

Method: Binaural loudness and pitch matches were measured by presenting sinusoid and amplitude-modulated noise stimuli, using an originally developed software application for smartphone devices. Subjects reported the potentially infected ear in the beginning of the process. Participants conducted the provided tests every day for 14 days via their smartphones using typical headphones in a quiet environment. The procedure was automatically controlled by Randomized Maximum Likelihood sequential procedure. 

Results: Subjects with Meniere’s disease required significantly higher intensities to obtain equal loudness than normal-hearing participants (p<0.05). Binaural pitch matches of the patient group did not differ remarkably from the normal, but showed larger daily fluctuations at tests of low- frequency stimuli (median>6%, IQR>7%). Perceptual pitch ability is better in sine-measurements comparing to those with SAM noise for both groups. In general, SAM noise results were similar between the two groups (p=0.88). 

Conclusions: The proposed application may constitute the beginning of collecting sufficient and varied data on the peculiar Meniere’s disease, absent until now. Frequent and long-term recordings are expected to contribute to the timely diagnosis, delay and personalized treatment of the disease.

Stylou et al
A) Flowchart of the “Meniere Calendar” application, B) Final psychometric function fitted to data from a normal hearing participant (left) and a Meniere’s patient (right). C) Screenshots of the application’s environment