Improved sensitivity of electrocochleography in the diagnosis of Meniere's disease

Al-momani, Murad O.; Ferraro, John A.; Gajewski, Byron; Ator, Gregory A.

doi:10.3109/14992020903019338

Cited by 43 publications

(30 citation statements)

References 25 publications

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“…However, introducing more extensive measures such as SP/AP area ratio (Ferraro and Tibbils, 1999) in some studies appeared to increase the diagnostic sensitivity (Devaiah et al, 2003). By combining SP amplitude, SP area, SP/AP area ratio and total SP-AP area, sensitivity and specificity values increased to 92% and 84%, respectively (Al-momani et al, 2009). In contrast, Baba et al (2009) found that the combination of these parameters as well as using SP/AP area alone did not have greater sensitivity than SP/AP amplitude ratios.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Ups and Downs in 75 Years of Electrocochleography

Eggermont

2017

Front. Syst. Neurosci.

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Before 1964, electrocochleography (ECochG) was a surgical procedure carried out in the operating theatre. Currently, the newest application is also an intra-operative one, often carried out in conjunction with cochlear implant surgery. Starting in 1967, the recording methods became either minimal- or not-invasive, i.e., trans-tympanic (TT) or extra tympanic (ET), and included extensive studies of the arguments pro and con. I will review several valuable applications of ECochG, from a historical point of view, but covering all 75 years if applicable. The main topics will be: (1) comparing human and animal cochlear electrophysiology; (2) the use in objective audiometry involving tone pip stimulation—currently mostly pre cochlear implantation but otherwise replaced by auditory brainstem response (ABR) recordings; (3) attempts to diagnose Ménière’s disease and the role of the summating potential (SP); (4) early use in diagnosing vestibular schwannomas—now taken over by ABR screening and MRI confirmation; (5) relating human electrophysiology to the effects of genes as in auditory neuropathy; and (6) intracochlear recording using the cochlear implant electrodes. The last two applications are the most recently added ones. The “historical aspects” of this review article will highlight the founding years prior to 1980 when relevant. A survey of articles on Pubmed shows several ups and downs in the clinical interest as reflected in the publication counts over the last 75 years.

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Section: Clinical Applicationsmentioning

confidence: 99%

Ups and Downs in 75 Years of Electrocochleography

Eggermont

2017

Front. Syst. Neurosci.

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“…In addition to a click SP/AP ratio Ferraro and Tibbils (1999) recorded the AP using an ET electrode. He advocated the addition of an SP/AP area ratio (Ferraro and Tibbils, 1999) to improve the sensitivity and specificity to 92 and 84%, respectively (Al-momani et al, 2009). However, Marcio et al (transtympanic) (Marcio et al, 2006) and Ikino et al (transtympanic) (Ikino and de Almeida, 2006) could not confirm it.…”

Section: Click Sp/ap Studies In Meniere's Diseasementioning

confidence: 99%

Tone Burst Electrocochleography for the Diagnosis of Clinically Certain Meniere's Disease

Hornibrook

2017

Front. Neurosci.

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The technique of transtympanic electrocochleography was initially developed as an objective hearing threshold test by Eggermont. Gibson et al. (1977) claimed that an enlarged direct current component of the action potential (AP) called the summating potential (SP) is an indication of endolymphatic hydrops, later confirmed by Coates who proposed an SP/AP ratio measure. This led to numerous publications using diagnostic ratios of 0.33–0.35. The insensitivity led to an eventual disenchantment with the test as a reliable objective test for Meniere's disease. It was further confused by audiologists employing remote canal or ear drum electrodes which give a response about one-fourth of the magnitude obtained by an electrode in contact with the cochlea. Subsequently Gibson stated that an SP/AP ratio of <0.5 is not diagnostic for hydrops. He then showed that a tone burst stimulus gave the test a significantly higher sensitivity and specificity, which has been supported by others. On MRI inner ear imaging with gadolinium hydrops can be seen, but the quality of images and what is seen may vary according to brand of scanner, settings, mode of gadolinium administration, and the possibility that gadolinium entry may favor the vestibule. Transtympanic tone burst electrocochleography is to date the simplest, cheapest and most sensitive technique for detecting cochlear endolymphatic hydrops to confirm a diagnosis of Meniere's disease.

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“…The application of ECochG to both clinical and research purposes is extensive and its use as a diagnostic tool for Ménière's disease has long been considered. While specific criteria have been examined, such as the use of the summating potential (SP)/compound action potential (AP) amplitude ratio, the relatively low sensitivity of this measure alone has limited its diagnostic value for Ménière's disease (Ferraro and Tibbils, 1999; Ferraro and Durrant, 2006; Al-momani et al, 2009). The lack of sensitivity of the SP/AP ratio measure obtained from click stimuli, and the unknown origins of the disease, has led to the continued refinement of ECochG uses to advance the differential diagnosis of Ménière's disease.…”

Section: Introductionmentioning

confidence: 99%

Human Summating Potential Using Continuous Loop Averaging Deconvolution: Response Amplitudes Vary with Tone Burst Repetition Rate and Duration

et al. 2017

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Electrocochleography (ECochG) to high repetition rate tone bursts may have advantages over ECochG to clicks with standard slow rates. Tone burst stimuli presented at a high repetition rate may enhance summating potential (SP) measurements by reducing neural contributions resulting from neural adaptation to high stimulus repetition rates. To allow for the analysis of the complex ECochG responses to high rates, we deconvolved responses using the Continuous Loop Averaging Deconvolution (CLAD) technique. We examined the effect of high stimulus repetition rate and stimulus duration on SP amplitude measurements made with extratympanic ECochG to tone bursts in 20 adult females with normal hearing. We used 500 and 2,000 Hz tone bursts of various stimulus durations (12, 6, 3 ms) and repetition rates (five rates ranging from 7.1 to 234.38/s). A within-subject repeated measures (rate x duration) analysis of variance was conducted. We found that, for both 500 and 2,000 Hz stimuli, the mean deconvolved SP amplitudes were larger at faster repetition rates (58.59 and 97.66/s) compared to slower repetition rates (7.1 and 19.53/s), and larger at shorter stimulus duration compared longer stimulus duration. Our concluding hypothesis is that large SP amplitude to short duration stimuli may originate primarily from neural excitation, and large SP amplitudes to long duration, fast repetition rate stimuli may originate from hair cell responses. While the hair cell or neural origins of the SP to various stimulus parameters remains to be validated, our results nevertheless provide normative data as a step toward applying the CLAD technique to understanding diseased ears.

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Improved sensitivity of electrocochleography in the diagnosis of Meniere's disease

Cited by 43 publications

References 25 publications

Ups and Downs in 75 Years of Electrocochleography

Ups and Downs in 75 Years of Electrocochleography

Tone Burst Electrocochleography for the Diagnosis of Clinically Certain Meniere's Disease

Human Summating Potential Using Continuous Loop Averaging Deconvolution: Response Amplitudes Vary with Tone Burst Repetition Rate and Duration

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