Objective: To analyze through a systematic review and meta-analysis the proportion of patients with Menière's disease who present altered caloric and vHIT tests and to determine the prevalence of dissociation altered caloric test and normal vHIT in the diagnosis of Menière's disease.

Methods: The literature search was performed without restriction regarding the publication period on indexed data platforms. Articles evaluating patients with Menière's disease who underwent caloric test and vHIT were included. Two researchers independently conducted the analysis of the articles, promoting the selection and extraction of data, following the recommendations of the PRISMA method. In case of disagreement during the selection process, a third evaluator was included for analysis. After data extraction, the study consisted of two stages. In a first analysis, the objective was to evaluate the prevalence of patients with Menière's disease who presented alterations in caloric and vHIT tests alone. On the other hand, in a second moment, the objective was to evaluate the prevalence of the combination of results of these two tests, through the combination of 04 groups: (1) caloric test and normal vHIT; (2) altered caloric test and normal vHIT; (3) calic and vHIT test altered; (4) normal caloric proof and altered vHIT.

Results: We included 12 articles from a total of 427 initially selected studies, published between 2014 and 2021, with a total of 708 patients evaluated and mean age of 52.72 years. The prevalence of patients with Menière's disease with altered caloric test was 64% (95% CI=57–71%), while the prevalence of altered vHIT was only 28% (95%CI=16–40%). The prevalence of altered caloric test dissociation+normal vHIT was 47% (95% CI=37–57%).

Discussion: The dissociation of results in the caloric and vHIT test may be justified by the anatomophysiology of the ampolar crest, since the type II hair cells, with peripheral location, are responsible for low frequency stimuli and acceleration and are selectively affected in patients with Menière's disease. Thus, it is possible that Menière's disease causes an impairment in the vestibular apparatus responsible for processing low frequency responses.

Conclusion: The head-impulse test video and the caloric test consist of valuable tools for vestibular evaluation. The dissociation of findings between these two tests in patients with Menière's disease was more prevalent in this meta-analysis and may be the result of tonotopia of ciliary cells specialized in the ampolar crest, providing a possibility for the diagnosis of patients with this otoneurological condition.

Keywords: Menière's disease; Caloric test; Head-impulse test video; Ocular vestibule reflex.