Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (5): 20-26.doi: 10.6040/j.issn.1673-3770.1.2020.073

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Diagnostic value of electrocochleography using external auditory canal electrode in patients with Menieres disease

  

  • Received:2020-08-03 Published:2020-11-17

Abstract: Objectives This study was designed to evaluate the diagnostic value of extra-tympanic electrocochleography(ET-ECochG)in definite Ménières disease(MD)patients. Methods Fifty-eight definite MD patients(60 ears)underwent ET-ECochG using bronze foil electrodes. The medical history, as well as pure tone audiometry, ET-ECochG, and 3D FLAIR MRI data of each patient were collected. Meanwhile, forty healthy volunteers were enrolled as controls. The amplitudes, latencies, and durations of SP and AP, the SP/AP amplitude ratio(SP/AP), and the area ratio of SP/AP(Asp/Aap)were collected. An adjusted calculation method for Asp/Aap was proposed. The differences among the ET-ECochG results of the definite MD ears, contralateral asymptomatic ears, and normal ears were analyzed using the t-test and the Mann-Whitney U test. The associations of Asp/Aap of ET-ECochG with the clinical history, pure tone audiometry, and endolymphatic hydrops evaluated via MRI were analyzed. Results ET-ECochG was identified in 46 of 60 ears(76.67%). Using the receiver operating characteristic(ROC)curve, the optimal cutoff points of SP/AP and Asp/Aap were 0.38 and 2.42, respectively. The area under the ROC curve(AUC)of Asp/Aap(0.985)was higher than the AUC of SP/AP(0.920). The ET-ECochG results of the definite MD ears, including SP/AP, Asp/Aap, and SP duration, were significantly higher than those of the contralateral asymptomatic ears and normal ears(p<0.05). The duration and disease stages of MD were significantly associated with SP/AP. The degree of endolymphatic hydrops of the cochlea was correlated with SP/AP and Asp/Aap, whereas the degree of vestibular hydrops only correlated with Asp/Aap. Conclusion SP/AP and Asp/Aap may be indicative of the degree of endolymphatic hydrops. Thus, ET-ECochG is useful for the clinical diagnosis of MD.

Key words: Extra-tympanic electrocochleography, Amplitude ratio, Area ratio, Menieres disease, Endolymphatic hydrops

CLC Number: 

  • R764.43
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[1] ZHANG Yaoyao,WANG Haitao. The application of MRI technology with intratympanic gadolinium injection in the diagnosis and treatment of Meniere's disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 101-107.
[2] To determine the therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease.MethodsClinical data of patients with unilateral intractable Menieres disease who underwent retrolabyrinthine vestibular neurectomy were retrospectively investigated. Therapeutic effectiveness was analyzed, and the safety and reliability of the procedure was discussed. ResultsThe mean duration of the disease was .±. months. Preoperative pure tone average of Hz, Hz, Hz, and Hz was(.±.)dB HL. Two cases were stage Ⅱ, cases were stage Ⅲ, and cases were stage Ⅳ. Two stage Ⅱ patients were recurrent cases after endolymphatic sac decompression surgery. Intracranial infection in case(.%), cerebrospinal fluid leakage in cases(.%), temporal facial nerve palsy in case(.%), incision infection in cases(.%), and fat liquefaction in cases(.%)were observed postoperatively. There was no case of intracranial hemorrhage or total deafness. Therapeutic effectiveness for relieving vertigo was level A in cases and level B in cases. ConclusionThe therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease is definite. Surgical risk and postoperative complications are controllable, and the quality of life can be significantly improved after surgery.. Therapeutic effectiveness of 75 cases of retrolabyrinthine vestibular neurectomy for intractable Menieres disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 46-50.
[3] HUANG Qiao,YIN Shihua. Correlation between endolymphatic hydrops and inner ear epithelial sodium channels and aquaporins [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 145-148.
[4] . Comparison of endolymphatic spaces between patients suffering from menieres disease and normal volunteers. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(2): 39-42.
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