Investigating the Characteristics of the Subjective Visual Vertical Test (Mental Perception of the Vertical Line) in People with Meniere’s Disease: Examining the Diagnostic Value of the Subjective Visual Vertical Test

Abstract Purpose: Meniere’s disease is an inner ear disorder that is not associated with involvement of central brain structures. Although the use of the ECHOG test has been common in recent years for diagnosing Meniere’s disease, it has not shown high sensitivity. Therefore, it is recommended to use other vestibular tests alongside the ECHOG test as complementary diagnostic tools. The use of subjective visual vertical (SVV) has gained popularity recently for the same reason. Hence, in this cross-sectional study, we aimed to investigate the results of SVV in patients with unilateral definitive diagnosis of Meniere’s disease and its diagnostic capability. Methods: This study was conducted on 53 people with definitive unilateral Meniere’s disease and a group of normal subject. Means were calculated with a 95% confidence interval for the groups, and the corresponding graphs were plotted. Independent t -test was subsequently used to examine the difference in SVV results between the normal and Meniere’s groups. Results: The findings indicate that there is no statistically significant distinction between the “Meniere” and “Healthy” groups in terms of their performance on the SVV test in the static or zero-degree position. Furthermore, the receiver operating characteristic curve analysis suggests that SVV, in the static condition, lacks the ability to differentiate between individuals with Meniere and those who are considered normal. When examining the influence of age on the extent of deviations in the SVV test, it was determined that age does not have a statistically significant impact on the extent of deviations ( P = −0.08, P = 0.571). Similarly, the analysis of gender’s effect on SVV deviations did not reveal any statistically significant differences ( t = −1.13, df = 51, P = 0.264). Conclusions: based on the findings, it can be concluded that the SVV test has relatively no sensitivity for diagnosing Meniere’s disease, and therefore, relying on its results for identifying Meniere’s patients is not recommended. It is suggested to use a combination of balance tests for diagnosing vestibular disorders, and a set of balance tests, alongside each other, helps in better localization and intensity assessment of the lesion for diagnosing both environmental and central balance disorders.