Use of electrocochleography in the diagnosis of meniere's disease

Levine, Samuel C.; Margolis, Robert H.; Daly, Kathleen A.

doi:10.1097/00005537-199807000-00008

Cited by 46 publications

(36 citation statements)

References 45 publications

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“…As reported previously [13][14][15] , the present study confirmed that the incidence of an abnormally elevated SP/ AP amplitude ratio is high in disease groups with endolymphatic hydrops. Especially MD had a high incidence of 57.6%, almost the same as reported by Baba et al [9] .…”

Section: Discussionsupporting

confidence: 92%

“…Indeed, the present study indicated that the ears with longer symptomatic duration and/or with severer symptoms had a tendency to develop a more abnormally elevated SP/AP ratio. In the previous reports [15][16][17] , it was commonly recognized that ECoG results are dependent on the disease duration. Meanwhile, a correlation between spells of vertigo and an elevation in the SP/AP ratio is thought to be unlikely [5,15,16] .…”

Section: Discussionmentioning

confidence: 99%

“…In the previous reports [15][16][17] , it was commonly recognized that ECoG results are dependent on the disease duration. Meanwhile, a correlation between spells of vertigo and an elevation in the SP/AP ratio is thought to be unlikely [5,15,16] . However, our present study revealed that frequent vertigo attacks correlated with an increase in SP/ AP amplitude ratio, especially in cases with a short disease duration of !…”

Section: Discussionmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Takeda

Kakigi

2010

ORL

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“…This excessive ratio likely signals an abnormal asymmetry in the sensory hair cell conductance, perhaps because hydrops distorts the cochlear partition: the summating potential can rapidly decrease in MD patients submitted to middle-ear pressure changes designed for reducing hydrops (e.g., Densert et al, 1997). The sensitivity of electrocochleography remains a matter of concern (Ferraro and Durrant, 2006), and so is its lack of obvious correlation with the ongoing symptoms of the disease (Levine et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Unstable distortion-product otoacoustic emission phase in Menière’s disease

et al. 2011

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“…Electrocochleography (ECoG) is generally performed to confirm the diagnosis of MD, but some investigators have reported its disadvantages: relatively low sensitivityVbelow 60% (3,4), no correlation with the stage of the disease or symptom duration (5), and continuous enlarged summating potential (SP)/action potential (AP) amplitude ratio after treatment during follow-up periods (6). The glycerol test is not widely used because it becomes an unpleasant or invasive test for patients on administration when it is administered.…”

mentioning

confidence: 99%

Diagnostic Efficiency of the Cochlear Hydrops Analysis Masking Procedure in Ménière’s Disease

Lee¹,

Choi²,

Park³

et al. 2011

Otology &Amp; Neurotology

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Objective: To determine whether cochlear hydrops analysis masking procedure (CHAMP) has diagnostic value in patients with definite Ménière's disease (MD) comparing the diagnostic validity index of CHAMP with those of electrocochleography (ECoG). Study Design: A prospective study. Setting: Tertiary referral center. Patients: One hundred eight patients were classified into 3 groups: the ''definite MD'' group (MD group, n = 47); the ''non-MD'' group (n = 41) of other vestibular diseases including vestibular neuritis, and benign paroxysmal positional vertigo; and the control group (n = 20), which included patients without dizziness. Interventions: CHAMP and extratympanic ECoG were performed in all patients. Main Outcome Measure: Sensitivity, specificity, and definitions of abnormal values were less than 0.3 ms in latency delay (0.5 kHz high pass noise [HPN]Yclick alone) and less than 0.95 in compound amplitude ratio (click aloneY0.5 kHz HPN/click alone) in CHAMP and 0.4 for the summating potential/action potential ratio in ECoG. Results: The mean latency delay and amplitude ratio of CHAMP in the MD group significantly differed from these values for other groups, whereas the mean summating potential/ action potential ratio of ECoG did not. In ECoG, sensitivity was as low as 21%, specificity was 97%, and diagnostic accuracy was 62%. Sensitivity, specificity, and diagnostic accuracy of CHAMP were 64%, 98%, and 80%, respectively, in latency delay and 91%, 83%, and 88%, respectively, in amplitude ratio. The sensitivity and diagnostic accuracy of CHAMP were significantly higher than the corresponding values for ECoG. Conclusion: CHAMP is more valuable in detection of definite MD than extratympanic ECoG. Key Words: Amplitude ratioVCochlear hydrops analysis masking procedureV Endolymphatic hydropsVLatency delayVMénière's diseaseV SensitivityVSpecificity.

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Use of electrocochleography in the diagnosis of meniere's disease

Cited by 46 publications

References 45 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

Unstable distortion-product otoacoustic emission phase in Menière’s disease

Diagnostic Efficiency of the Cochlear Hydrops Analysis Masking Procedure in Ménière’s Disease

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