MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Ménière’s Disease

Hornibrook, Jeremy; Flook, Edward; Greig, Sam; Babbage, Melissa J.; Goh, Tony; Coates, Mark; Care, Rachel; Bird, Philip

doi:10.1097/mao.0000000000000782

Cited by 52 publications

(44 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hornibrook et al (18) prospectively compared the sensitivity of gadolinium MRI inner ear imaging with EcoG. The results show that MRI with intratympanic gadolinium administration (33.3%) has a higher positive rate for detecting endolympathic hydrops in patients with Ménière's disease compared with EcoG (24.6%) ( Table 2).…”

Section: Data Extractionmentioning

confidence: 90%

“…After screening on title and abstract (n ¼ 1,002), 17 articles were assessed on full-text for eligibility. A total of four articles were included in the critical appraisal (18)(19)(20)(21). Reference and citations tracking did not result in more articles.…”

Section: Data Extractionmentioning

confidence: 99%

“…In all studies patients with Ménière's disease were diagnosed based on the AAO-HNS score, including clinical findings and audiometric tests (2,(18)(19)(20)(21). The baseline characteristics of all included studies are shown in Table 1.…”

Section: Data Extractionmentioning

confidence: 99%

“…After quality assessment, all four studies were used for further data extraction and analysis (18)(19)(20)(21).…”

Section: Quality Assessmentmentioning

confidence: 99%

See 3 more Smart Citations

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

Ziylan

Smeeing²,

Stegeman³

et al. 2016

Otology &Amp; Neurotology

View full text Add to dashboard Cite

Objective: To evaluate the diagnostic value of electrocochleography compared with magnetic resonance imaging (MRI) with intratympanic gadolinium administration to diagnose endolymphatic hydrops in patients with Ménière's disease. Data Sources: An electronic search was performed in the PubMed, EMBASE, and Cochrane databases on September 15, 2015. A systematic search was conducted. Articles were included if written in English, Dutch, German, or French language. Study Selection: Original studies reporting on the diagnostic value of electrocochleography compared with MRI with intratympanic gadolinium administration, were included. Data Extraction: The methodological quality of the studies was independently assessed by two reviewers using an adjusted version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. The results of the diagnostic values of both tests were extracted.Data Synthesis: We performed analyses for the sensitivity, specificity, positive predictive value, and negative predictive value of compared electrocochleography with MRI with intratympanic gadolinium administration in patients with definite Ménière's disease. Conclusion: The results of this systematic review, based on a very low number of patients, show there is a relative low sensitivity and negative predictive value for click stimulus electrocochleography compared with MRI with intratympanic gadolinium administration for detecting endolymphatic hydrops in patients with definite Ménière's disease.

show abstract

Section: Data Extractionmentioning

confidence: 90%

Section: Data Extractionmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

“…After quality assessment, all four studies were used for further data extraction and analysis (18)(19)(20)(21).…”

Section: Quality Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

Ziylan

Smeeing²,

Stegeman³

et al. 2016

Otology &Amp; Neurotology

View full text Add to dashboard Cite

show abstract

“…Tone burst EcoG positively detected EH in 25 cases (83%), whereas gadolinium MRI was positive in (47%). The authors conclude that EcoG was a more sensitive test [35].…”

Section: British Journal Of Research Issn 2394-3718mentioning

confidence: 99%

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

Mowat¹

2017

Br J Res

View full text Add to dashboard Cite

Meniere's disease (MD) represents a diagnostic challenge. It's symptoms of episodic vertigo, hearing loss, tinnitus, and a sense of aural fullness share overlap with multiple other conditions. It remains a diagnosis of exclusion, with imaging only used to rule out other pathologies, notably acoustic neuroma. Technological advance has brought increased resolution to the inner ear. In the future it is likely that MD will become a radiological diagnosis.Keywords: Hydrops; Imaging; Dizziness; Vertigo Meniere's DiseaseCurrently, the primary role of imaging in the investigation of suspected MD is to exclude other pathology. MD can present with asymmetrical hearing loss. In such circumstances it is usual to perform an MRI to exclude an acoustic neuroma or other forms of cerebellopontine angle tumour. The guidance on precisely when a patient requires an MRI to investigate asymmetrical SNHL is less clear. A comparison of eight screening protocols found that the best compromise between sensitivity and specificity was achieved by a criterion requiring either a 20 dB asymmetry at two neighbouring frequencies, or 15 dB asymmetry at two frequencies between 2 and 8 kHz [1]. Similarly, in the vertiginous patient an MRI can be used to exclude, space occupying lesions such as endolymphatic sac tumours, cholesteatoma fistulas, and brain metastasis [2].In the acute setting, the symptoms of a Meniere's attack can be mimicked by an anterior inferior cerebellar artery (AICA) stroke, which shares the symptoms of vertigo, tinnitus, deafness. The other symptoms of hemiplegia, and facial weakness offer greater distinction. However, all patients presenting with such a first episode of such symptoms should have a Computed Tomography (CT) scan to exclude a central cause [3]. The symptoms of AICA occlusion, display the lack of collateral vessels to the inner ear and its high metabolic rate, an anatomical fact which may have a bearing on the pathophysiology of MD.The future importance of imaging in the investigation of the suspected MD patient will depend on the other diagnostic modalities with which it is competing. Therefore it is necessary to comparatively discuss their diagnostic accuracy.A pure tone audiogram (PTA) is a basic step in the Meniere's diagnosis. MD classically produces a fluctuating low frequency hearing loss that becomes permanent as the disease progresses. However, it can cause many other patterns of hearing loss, which may mimic differentials such as otosclerosis, or noise induced losses [4]. Electronystagmography(ENG), is another routine investigation as MD causes a reduced vestibular response in the ear affected. However, it has limited sensitivity as recent work shows only a 50% positive rate in confirmed MD cases [5].Electrocochleography (ECoG) provides electrophysiological verification. An elevated summating potential/ nerve action potential of greater than 35% is a sign of MD. However, whilst a useful part of the diagnostic battery, specificity and sensitivity remains low particularly when performed in betwee...

show abstract

Click SP/AP Area Ratio Vesrus Tone Burst SP Amplitude to Diagnose Ménière's Disease Using Electrocochleography

Bawazeer,

Gagnon,

Maheu

et al. 2024

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

ObjectivesTo evaluate the sensitivity and the specificity of summating potential (SP)/action potential (AP) area under the curve (AUC) ratio by a transtympanic electrode and a click stimulus (TT‐CS), SP/AP AUC ratio by an extratympanic electrode and a click stimulus (ET‐CS) and SP amplitude value by a transtympanic electrode and tone burst stimulus (TT‐TBS) in regard of Ménière's disease (MD) diagnosis. This is the first study that compares SP amplitude value performed by a TT‐TBS and the SP/AP AUC ratio performed by a TT‐CS.Study DesignRetrospective comparative study.SettingsNinety‐five patients met the inclusion criteria for electrocochleography (ECochG) testing in a tertiary care center.MethodsThe sensitivity and specificity of our different ECochG protocols were calculated in regard of the diagnosis of MD.ResultsThe patients' mean age was 54 years old (female predominance). The sensitivity and the specificity of SP/AP area ratio by a TT‐CS were 88.5% and 70.0%, respectively. On the other hand, the sensitivity and specificity for the SP amplitude value by a TT‐TBS were 60.0% and 55.6%, respectively. SP/AP area ratio by TT‐CS was statistically better than SP amplitude value by TT‐TBS to detect MD disease (P = .016). However, no difference was identified between SP/AP area ratio by ET‐CS and SP amplitude value by a TT‐TBS (P = .573).ConclusionSP/AP area ratio by click stimulation has higher sensitivity and specificity to detect MD compared to SP amplitude value by tone burst stimulation. ECochG would be extremely useful in the diagnosis of MD if we use the SP/AP area ratio (sensitivity: 88.5%); therefore, it changes the bad reputation of ECochG sensitivity using SP/AP amplitude ratio (sensitivity: 51.7%) for the diagnosis of MD.

show abstract

MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Ménière’s Disease

Cited by 52 publications

References 15 publications

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

Click Stimulus Electrocochleography Versus MRI With Intratympanic Contrast in Ménière's Disease

What is the Current and Potential Future Role of Imaging in the Investigation of Patients with Suspected Meniere's Disease?

Click SP/AP Area Ratio Vesrus Tone Burst SP Amplitude to Diagnose Ménière's Disease Using Electrocochleography

Contact Info

Product

Resources

About