Intraoperative Electrocochleography of Endolymphatic Hydrops Surgery Using Clicks and Tone Bursts

Arenberg, I. Kaufman; Kobayashi, Hideto; Obert, A. D.; Gibson, W. P. R.

doi:10.3109/00016489309128124

Cited by 16 publications

(14 citation statements)

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“…Significant increases in SP amplitude result from experimental displacement of the basilar membrane toward the scala tympani, either by increasing hydrostatic pressure above the basilar membrane (19) or by low-frequency biasing (20). Clinical SP elevation may reflect hydromechanical changes within the scala media caused by a relative increase in endolymphatic fluid pressure (17), explaining the elevated SP/AP observed in two-thirds of patients with Ménière's disease (21) and in animal models of hydrops (22). Moreover, elevation in SP/AP has been acutely induced by suctioning perilymph from surgically generated round window fistulas (PLFs) in guinea pigs.…”

Section: Discussionmentioning

confidence: 98%

“…The SP is a direct current potential that consists of a shift, positive or negative in polarity, from the baseline upon which the cochlear microphonic is superimposed (16). It is thought to reflect nonlinear properties of cochlear hydrodynamics and basilar membrane mechanics (17). Both inner and outer hair cells likely contribute to the production of the SP (18).…”

Section: Discussionmentioning

confidence: 99%

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Electrocochleography as a Diagnostic and Intraoperative Adjunct in Superior Semicircular Canal Dehiscence Syndrome

Adams¹,

Kileny

Telian

et al. 2011

Otology &Amp; Neurotology

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Electrocochleography as a Diagnostic and Intraoperative Adjunct in Superior Semicircular Canal Dehiscence Syndrome

Adams¹,

Kileny

Telian

et al. 2011

Otology &Amp; Neurotology

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“…Although still controversial, decompression or shunting of the endolymphatic sac is an option for patients who fail nonsurgical treatments. During such surgeries, instantaneous measurements of the mechanoelectrical processes of the inner ear can be achieved via ECochG (Gibson et al, 1988;Gibson and Arenberg, 1991;Arenberg et al, 1993;Wazen, 1994;Mishler et al, 1994). Figure 10 exemplifies intraoperative changes in the electrocochleogram induced by probing for the endolymphatic duct in a patient with MD/ELH.…”

Section: Surgery Committee On Hearing Andmentioning

confidence: 99%

Electrocochleography in the Evaluation of Patients with Ménière's Disease/Endolymphatic Hydrops

Ferraro

Durrant²

2006

J Am Acad Audiol

100

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Electrocochleography (ECochG) has evolved as an important tool in the diagnosis/assessment/monitoring of Ménière's disease/endolymphatic hydrops (MD/ELH). This manuscript provides an update on the use of ECochG for these purposes. The material presented includes descriptions of the components of the electrocochleogram; ECochG recording approaches and parameters; how to prepare for an exam, including subject/patient considerations; construction and placement of a tympanic membrane recording electrode; and interpretation the electrocochleogram. Various approaches aimed at improving ECochG's sensitivity and specificity to MD/ELH also are described. These approaches go beyond simple measurement of the now-conventional summating potential (SP)/action potential (AP) magnitude ratio to include the SP magnitude to tonebursts, the SP/AP area ratio, and the AP latency difference to clicks of opposing polarity.

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“…At present, the correlation between changes in ECochG during the treatment of endolymphatic hydrops and the therapeutic outcome is still controversial. The 2 studies of Arenberg and Martin‐Sanz both show that the SP/AP ratio decreased after the treatment of endolymphatic hydrops, but no follow‐up data were reported. In this study, the ESD surgery was performed, and the patients were followed up for 1 year with ECochG.…”

Section: Discussionmentioning

confidence: 99%

Signs of electrocochleography on endolymphatic sac decompression for patients with Ménière's Disease: Our experience in 12 patients

Yan

Zhu

et al. 2018

Clinical Otolaryngology

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Endolymphatic hydrops (ELH) is a well-established histological marker of M eni ere's disease (MD). The diagnosis of MD still depends on clinical symptoms complemented with inner ear function tests. Thus far, definitive diagnosis remains difficult. It is necessary for clinicians to explore an objective examination to diagnose MD and to monitor patients' ELH. Endolymphatic sac decompression (ESD) provides pressure relief and allows for expansion of the endolymphatic sac by removal of the mastoid bone, after which episodic vertigo attacks decrease in frequency. Currently, ESD has been demonstrated as an effective surgical option for MD. 1,2 Nevertheless, the indication for ESD and the change in ELH after ESD surgery are unclear. Electrocochleography (ECochG) is an important, objective tool in the diagnosis, assessment and monitoring of ELH. However, some researchers consider ECochG to be a controversial diagnostic indicator due to the fluctuating course of MD/ELH. 3,4The aim of this study was to identify signs of ECochG for MD patients who received ESD surgery during their 1-year postoperative follow-up. | MATERIALS AND METHODS | Ethical considerationsThe study was reviewed and approved by the Institutional Ethical Review Board of the First Affiliated Hospital of Chongqing Medical University and was conducted in compliance with the Helsinki declaration. | PatientsTwelve patients with definite MD were enrolled in this prospective study between May 2014 and May 2016. The inclusion criteria for the patients were as follows: (i) MD diagnosis according to the 1995 AAO-HNS guidelines; (ii) recurrent vertigo spells refractory to a lowsalt diet and medical treatment for at least 1 year; (iii) no medical evidence of central nervous system involvement; and (iv) willingness to complete 1 year of regular postoperative follow-up examinations.All of the above patients were followed up regularly for 12 months after the surgery by an outpatient service or the telephone. wileyonlinelibrary.com/journal/coa Clinical Otolaryngology. 2018;43:920-969. 922 | CORRESPONDENCE: OUR EXPERIENCE the short term; however, they become ineffective after long-term use. Furthermore, the goal of ESD is to remove the bone outside of the endolymphatic sac and the superficial layer of the dura so that the endolymphatic sac has space for better expansion and so that the endolymph in the membranous labyrinth can reach a new pressure equilibrium in the process of continuous secretion and absorption. Although this was a small cohort study with a short-term followup, it provides useful signs for utilising ECochG to diagnose MD and to monitor ELH changes after ESD surgery. First, the ECochG test, especially the SP/AP area ratio, could safely diagnose MD, and there was no latent damage to the inner ear Second, we speculate that the result of the ECochG test could predict the ESD postoperative improvement by virtue of the SP/AP values. Higher values could indicate more endolymphatic pressure relief, that is more vertigo control. Therefore, we report that this pil...

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Intraoperative Electrocochleography of Endolymphatic Hydrops Surgery Using Clicks and Tone Bursts

Cited by 16 publications

References 10 publications

Electrocochleography as a Diagnostic and Intraoperative Adjunct in Superior Semicircular Canal Dehiscence Syndrome

Electrocochleography as a Diagnostic and Intraoperative Adjunct in Superior Semicircular Canal Dehiscence Syndrome

Electrocochleography in the Evaluation of Patients with Ménière's Disease/Endolymphatic Hydrops

Signs of electrocochleography on endolymphatic sac decompression for patients with Ménière's Disease: Our experience in 12 patients

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