Diagnostic Usefulness of Multifrequency Tympanometry for Ménière’s Disease

Abstract

Multifrequency tympanometry (MFT) is the measurement of the impedance of the middle ear transmission system at a wide range of frequencies from 200 Hz to 2 kHz. A potential use of MFT as a new diagnostic tool for detecting endolymphatic hydrops has recently been reported. However, its clinical usefulness for diagnosing Ménière’s disease (MD) remains unclear. To evaluate the clinical usefulness of MFT as a new qualitative and diagnostic test for MD, we performed MFT in 70 patients with unilateral or bilateral MD and in 29 normal control subjects. The width of double peaks in the admittance tympanograms (Y width) at 2 kHz and the resonance frequency (RF) were analyzed, and receiver operating characteristic (ROC) curves were constructed. The Y width in MD-affected ears was significantly greater than that in control ears (p < 0.001). The RF in MD-affected ears was significantly lower than that in control ears (p < 0.01). Neither the Y width nor RF had a significant relationship with hearing levels or the results of caloric and vestibular myogenic potential testings. The area under the ROC curve was 0.71 for the Y width and 0.66 for the RF. At the optimal cutoff points, the sensitivity and specificity of the Y width were 47.3 and 86.8%, respectively, and those of the RF were 41.3 and 84.2%, respectively. These results indicated that MFT is significantly associated with the presence of MD, but its diagnostic accuracy is only modest. MFT is a simple, noninvasive test, which should be considered as a complementary test in the diagnosis of MD.

Decrease in Middle Ear Resonance Frequency during Pregnancy

“…In the preliminary study of Franco-Vidal et al, 11 RF level in the symptomatic ears of 40 patients with Ménière’s was measured as 752 Hz while this level was 820 Hz in asymptomatic ears. Sugasawa et al 12 confirmed the previous results in their study conducted on Ménière’s disease patients. Although endolymphatic fluid increase is not at pathological level during pregnancy, a similar mechanism that occurred in Ménière’s disease can also be mentioned in pregnant women.…”

Effects of Body Tilt on Multifrequency Admittance Tympanometry

“…The apparent increase in RF with increasing body tilt was unexpected (although this result was not statistically significant), as previous studies in MD patients have reported a clear decrease in RF between attacks (6,12). RF corresponds to the equilibrium between the rigidity and the mass of the components of the middle and inner ears.…”

“…In recent years, three studies have confirmed these findings (12Y14). In 2013, Sugasawa et al (12) used admittance to demonstrate the same decrease in RF and the same increase in width tympanograms in MD patients compared with controls. As in our study, the MD patients were tested outside an attack (6).…”

Test-Retest Reliability of the Components of Multi-Frequency Tympanometry

“…It has been proposed that increased endolymph space alters the mechanical impedance of the stapes footplate, leading to the "third-window" effect, which may reduce the RF of the middle ear [14] . Multi-frequency tympanometry is also used as a simple, noninvasive, complementary test in the diagnosis of endolymphatic hydrops [15] . Considering these wide applications of the components of multi-frequency tympanometry, its test-retest reliability was assessed for determining efficient clinical application of these measures.…”