Impact of Bilaterality and Headache on Health-Related Quality of Life in Meniere's Disease

Objectives: We analyzed the impact of bilaterality and headache on the health- related quality of life (HRQL) of patients with Meniere's disease (MD). Methods: A case series including 86 patients with a diagnosis of definite MD according to the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) diagnostic criteria was evaluated by the Short Form 36 (SF-36) Health Instrument and the Dizziness Handicap Inventory Short Form (DHI-S). Results: The scores on all scales of the SF-36 were significantly lower for bilateral MD than for unilateral cases, except for body pain. Both groups had scores worse than those of their sex- and age-matched normative population on all SF-36 scales (p = 0.017 to p = 0.0001), except for body pain in men. The DHI-S scores were also better for unilateral than for bilateral cases (p = 0.04), suggesting that the dizziness is perceived to be more disabling in bilateral MD. Migraine was significantly associated with bilateral MD (odds ratio, 3.58 [95% confidence interval, 1.25 to 10.31]; p = 0.021). Headache and score on the AAO-HNS functional scale, which evaluates the effect of vertigo attacks on daily activities, were two independent factors that explained a great part of the variability on all SF-36 scales, except for role emotional in bilateral MD. Conclusions: Patients with bilateral MD perceived their dizziness to be more disabling and had a worse HRQL than did patients with unilateral MD. Migraine was more frequently found in patients with bilateral involvement. Headache and score on the AAO-HNS functional scale were factors associated with the HRQL in bilateral MD.