Diagnostic Value of Plasma Antidiuretic Hormone, Electrocochleography, and Glycerol Test in Patients with Endolymphatic Hydrops

Taguchi, Daizo; Kakigi, Akinobu; Takeda, Taizo; Sawada, Shoichi; Nakatani, Hiroaki

doi:10.1159/000265117

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…In ECoG diagnosis of MD, these characteristics of ECoG must be considered. We improved the detection rate of endolymphatic hydrops by the combination of ECoG, the glycerol test and the measurement of plasma vasopressin levels [29] . If the diagnosis could be anchored in the patient's clinical history, symptoms, audiogram and dehydration tests including the glycerol test, extratympanic ECoG may play an important diagnostic role, especially in MD patients with less definite symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

Takeda

Kakigi

2010

ORL

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Objective: To evaluate the clinical conditions causing an elevation in the click-evoked summation potential (SP)/action potential (AP) amplitude ratio (SP/AP ratio), the cause of the SP enhancement in Ménière’s disease (MD) and the diagnostic efficacy of electrocochleography (ECoG) were discussed. Study Design: Retrospective case review. Setting: An outpatient clinic of the Otolaryngology Department of Kochi Medical School. Patients: ECoG testing was performed in 632 patients (727 ears) with vertigo/dizziness and/or deafness over a 10-year period (1995–2005). Among them, 334 patients had diagnoses of definite MD, including 95 cases of bilateral involvement. Main Outcome Measures: Audiological thresholds and SP/AP ratio. Results: An enhanced SP was observed in 56.3% of patients with MD. The incidence of an enhanced SP was low in patients for whom the disease duration was 2 years or less and the frequency of attacks was once a year or less, but was significantly higher in cases where the disease duration was 2 years or longer and/or the frequency of attacks was several times a year (Games-Howell test, p < 0.05). The incidence of an enhanced SP was significantly elevated in cases with pure-tone average exceeding 31 dB (Kendall’s rank correlation test, p < 0.001). However, the enhanced SP, once it appeared, did not always disappear in spite of hearing improvement. Hearing improvement induced by the glycerol test also produced no alteration in an SP/AP ratio, and there was no significant difference between the glycerol test results and the incidence of an enhanced SP (χ² goodness-of-fit test). Conclusions: The longer the patients were symptomatic or the severer the ear symptoms, the more likely the ECoG was to be positive. The abnormally elevated SP, once it had appeared, persisted for long periods. Spontaneous and glycerol-induced hearing gains did not result in a decrease in SP/AP ratio. These clinical characteristics of ECoG seem to indicate that the enhanced SP in MD might be caused by the malfunction of hair cells, not by the displacement of the basilar membrane toward the scala tympani.

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Section: Discussionmentioning

confidence: 99%

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

Takeda

Kakigi

2010

ORL

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“…Even taken together, the two functional tests were not competitive (only 15 patients showed a positive result in at least one test). This does not surprise considering that claims about the superiority of a combination of electrocochleography and glycerol test compared to the single tests [ 57 , 58 ] are not well founded (false positives are left unconsidered).…”

Section: Discussionmentioning

confidence: 99%

Reappraisal of the glycerol test in patients with suspected Menière’s disease

Lütkenhöner

Basel

2014

BMC Ear Nose Throat Disord

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BackgroundRecent advances in magnetic resonance imaging make it possible to visualize the presumed pathophysiologic correlate of Menière’s disease: endolymphatic hydrops. As traditional diagnostic tests can provide only indirect evidence, they are hardly competitive in this respect and need to be rethought. This is done here for the glycerol test.MethodsThe data of a previous retrospective analysis of the glycerol test in patients with suspected Menière’s disease are reinterpreted using a simple model. The mean threshold reduction (MTR) in the frequency range from 125 to 1500 Hz (calculated from audiograms obtained immediately before and four hours after the glycerol intake) is used as the test statistic. The proposed model explains the frequency distribution of the observed MTR by the convolution of a Gaussian probability density function (representing measurement errors) with a template representing the frequency distribution of the true MTR. The latter is defined in terms of two adjustable parameters. After fitting the model to the data, the performance of the test is evaluated using receiver operating characteristic (ROC) analysis.ResultsThe cumulative frequency distribution of the observed MTR can be explained almost perfectly by the model. According to the ROC analysis performed, the capability of the currently used audiometric procedure to detect a glycerol-induced threshold reduction corresponds to a diagnostic test of rather high accuracy (area under the ROC curve greater than 0.9). Simulations show that methodological improvements could further enhance the performance.ConclusionsOwing to their ability to reveal functional aspects without an obvious morphological correlate, traditional test for Menière’s disease could be decisive for defining the stage of the disease. A distinctive feature of the glycerol test is that it is capable of determining, with high accuracy, whether the pathophysiologic condition of the inner ear is partially reversible. Prospectively, this could help to estimate the chances of specific therapies.

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“…Kimura et al reported that 97% of 118 patients with definite MD showed at least one positive test result in a battery of three tests, and that the combination of three rather than two tests resulted in an improved diagnostic accuracy [6]. Taguchi et al also showed that 97% of 60 patients with ELH had at least one positive result in a battery of p-ADH, ECoG, and the glycerol test [8]. The furosemide test and p-ADH are highly sensitive.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the diagnostic value of 3 T MRI after intratympanic injection of GBCA, electrocochleography, and the glycerol test in patients with Meniere's disease

Fukuoka¹,

Takumi²,

Tsukada³

et al. 2011

Acta Oto-Laryngologica

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Conclusion.3 T MRI after intratympanic injection of gadolinium-based contrast agent (GBCA) is more useful for the diagnosis of endolymphatic hydrops compared with the glycerol test and electrocochleography (ECoG).Objective:To investigate the relationship between 3 T MRI after intratympanic injection of GBCA, the glycerol test, and ECoG in patients with Meniere's disease (MD).Methods:A total of 20 patients with MD were evaluated. Diluted gadodiamide (a gadolinium-based contrast agent) was administered to the bilateral tympanic cavity by injection through the tympanic membrane. After 24 h, the endolymphatic hydrops was evaluated by a 3.0 T MR scanner. To investigate cochlear hydrops, the glycerol test and ECoG were carried out in all patients.Results:A positive result was observed in 11 patients (55%) in the glycerol test and in 12 patients (60%) by ECoG. The incidence of positive findings when evaluating the same patients with both the glycerol test and ECoG increased to 75%. Nineteen of 20 (95%) patients showed positive results for 3 T MRI.

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Diagnostic Value of Plasma Antidiuretic Hormone, Electrocochleography, and Glycerol Test in Patients with Endolymphatic Hydrops

Cited by 4 publications

References 25 publications

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

Reappraisal of the glycerol test in patients with suspected Menière’s disease

Comparison of the diagnostic value of 3 T MRI after intratympanic injection of GBCA, electrocochleography, and the glycerol test in patients with Meniere's disease

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