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Reply published on 27 March 2025, see J. Clin. Med. 2025, 14(7), 2286.
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Comment

The Use of Multifrequency Tympanometry in Ménière’s Disease. Comment on Tsilivigkos et al. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476

Otorhinolaryngology and Head and Neck Surgery Department, University Medical Centre Utrecht, PB 85500, 3508 GA Utrecht, The Netherlands
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Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(2), 570; https://doi.org/10.3390/jcm14020570
Submission received: 29 October 2024 / Accepted: 28 December 2024 / Published: 17 January 2025
(This article belongs to the Section Otolaryngology)
With great interest, we have read the review article entitled ‘Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis’ [1]. The authors provided an extensive review and meta-analysis addressing the use of multifrequency tympanometry (MFT) as a diagnostic tool in people with Ménière’s disease (MD) or with similar symptoms. The authors discussed both studies that did (or did not) find a significantly greater G-width or Y-width in the multifrequency tympanograms compared to controls.
Based on their careful review, they concluded that MFT could be an important diagnostic test for people with MD. Compared to our study (de Jong et al., 2023 [2]), however, we did not find a significant difference in MFT results between the groups. As described by the authors and is well known concerning the physiologic mechanism of MFT, at the resonance frequency (RF), the admittance (Y) reflecting the acoustic energy that flows into the middle ear consists solely of the conductance (G). Therefore, these two overlap, and the outcome might be comparable. The authors only referred to the G-width (where they found some significant relation to MD), whereas the published articles concerning the Y-width did not show robust evidence supporting the value of MFT for the confirmation of MD. Similarly, the Y-width, as used in our study, did not prove to be significantly increased in MD patients. Based on the literature, it might well be possible that the G-width at 2 kHz in MFT has better diagnostic properties to indicate the presence of endolymphatic hydrops. As mentioned, at resonance frequency (RF), both Y- and G-widths are equal, but not necessarily at 2 kHz. The 2 kHz was chosen as it reflects the annular ligament and cochlear pressure.
The MFT, specifically the G-width, might be a useful tool to diagnose endolymphatic hydrops more than the MD itself, given the mentioned constraints. The explanation as to why we did not find a correlation and others did might be due to the fact that an endolymphatic hydrops can be present in healthy subjects without otovestibular complaints.
Further research is needed to better understand and support theories about pressure changes in MD, as well as the proper definition of actual MD. However, it will not change the fact that there are healthy subjects that demonstrate an increased Y- or G-width because of asymptomatic endolymphatic hydrops not related to MD. This must always be kept in mind. Until we better understand MD, MFT as a diagnostic test should, even in its best form, be used to rule out endolymphatic hydrops or support further evaluation, for example, with MRI hydrops.

Conflicts of Interest

The authors declare no conflict of interest.

References

  1. Tsilivigkos, C.; Vitkos, E.N.; Ferekidis, E.; Warnecke, A. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476. [Google Scholar] [CrossRef] [PubMed]
  2. de Jong, M.A.; van Esch, B.F.; van Benthem, P.P.G.; van der Zaag-Loonen, H.J.; Bruintjes, T.D.; Thomeer, H.G.X.M. The Diagnostic Value of Multifrequency Tympanometry in Patients with Ménière’s Disease: A Prospective Analysis. Audiol. Neurootol. 2023, 28, 272–279. [Google Scholar] [CrossRef] [PubMed]
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MDPI and ACS Style

de Jong, M.A.; Thomeer, H.G.X.M. The Use of Multifrequency Tympanometry in Ménière’s Disease. Comment on Tsilivigkos et al. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476. J. Clin. Med. 2025, 14, 570. https://doi.org/10.3390/jcm14020570

AMA Style

de Jong MA, Thomeer HGXM. The Use of Multifrequency Tympanometry in Ménière’s Disease. Comment on Tsilivigkos et al. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476. Journal of Clinical Medicine. 2025; 14(2):570. https://doi.org/10.3390/jcm14020570

Chicago/Turabian Style

de Jong, M. A., and H. G. X. M. Thomeer. 2025. "The Use of Multifrequency Tympanometry in Ménière’s Disease. Comment on Tsilivigkos et al. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476" Journal of Clinical Medicine 14, no. 2: 570. https://doi.org/10.3390/jcm14020570

APA Style

de Jong, M. A., & Thomeer, H. G. X. M. (2025). The Use of Multifrequency Tympanometry in Ménière’s Disease. Comment on Tsilivigkos et al. Can Multifrequency Tympanometry Be Used in the Diagnosis of Meniere’s Disease? A Systematic Review and Meta-Analysis. J. Clin. Med. 2024, 13, 1476. Journal of Clinical Medicine, 14(2), 570. https://doi.org/10.3390/jcm14020570

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