الفهرس 
INTRODUCTION AND RATIONALEOnly 14 pages are availabe for public view
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Abstract
MD is a chronic illness with considerable prevalence among population that disturb patients’ quality of life and productivity, with different lines of management as regard diagnosis and treatment, the decision of choosing which line of treatment for which case varies widely and is of great impact on cases, being a bilateral disease that starts unilaterally made the early diagnosis of other ear affection is of critical value in determining the plan of management.
This early diagnosis can be done as we concluded from this study by using DPOAEs S/N ratio specially at lower frequencies (1000 & 2000 Hz frequencies) that proved to be the slightly superior to VEMPs in early detection of hydrops. Despite being less sensitive than DPOAEs, c-VEMP FAR remains gold standard denoting early affection of saccular endolymphatic hydrops, also another parameter affected in c-VEMP is the 500 Hz frequency amplitude, results conducted by this study reflects that the least sensitive and the latest to be affected is the o-VEMP. However, there was one affected parameter of o-VEMP which is the 1000 Hz latencies, but this finding needs further work up.
We recommend scheduled and close follow up for unilateral MD cases, this follow up should include audiometric evaluation, DPOAEs and VEMPs which are rapid, effective and of great diagnostic value tests. Also the plan of treatment specially if it may include ablative or semi-ablative options should be determined according to the results of these evaluations.