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

Previous Articles     Next Articles

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
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 梅尼埃病诊断和治疗指南(2017)[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(3): 167-172. doi:10.3760/cma.j.issn.1673-0860.2017.03.002. Editorial Board of Chinese Journal of Otorhinolary, Society of Otorhinolaryngology Head and Neck Surge. Guideline of diagnosis and treatment of Meniere disease(2017)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(3): 167-172. doi:10.3760/cma.j.issn.1673-0860.2017.03.002.
[2] Gibson WP. The clinical uses of electrocochleography[J]. Front Neurosci, 2017, 11: 274. doi:10.3389/fnins.2017.00274.
[3] Al-momani MO, Ferraro JA, Gajewski BJ, et al. Improved sensitivity of electrocochleography in the diagnosis of Menieres disease[J]. Int J Audiol, 2009, 48(11): 811-819. doi:10.3109/14992020903019338.
[4] 王藁浴, 谢艳, 周慧芳, 等. 耳蜗电图面积比对梅尼埃病不同时期的诊断价值[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(14): 1142-1145. doi:10.13201/j.issn.1001-1781.2016.14.014. WANG Gaoyu, XIE Yan, ZHOU Huifang, et al. The value of area curve ratio electrocochleography in diagnosis of Menieres disease during different periods[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(14): 1142-1145. doi:10.13201/j.issn.1001-1781.2016.14.014.
[5] 雷艳, 康厚墉, 胡国华, 等. 耳蜗电图SP/AP面积比在梅尼埃病诊断中的应用研究[J]. 重庆医科大学学报, 2016, 41(6): 632-636. doi:10.13406/j.cnki.cyxb.000981. LEI Yan, KANG Houyong, HU Guohua, et al. Application of SP/AP area ratio of electrocochleography in the diagnosis of Menieres disease[J]. Journal of Chongqing Medical University, 2016, 41(6): 632-636. doi:10.13406/j.cnki.cyxb.000981.
[6] Eggermont JJ. Ups and Downs in 75 years of electrocochleography[J]. Front Syst Neurosci, 2017, 11: 2. doi:10.3389/fnsys.2017.00002.
[7] Lake AB, Stuart A. The effect of test, electrode, and rate on electrocochleography measures[J]. J Am Acad Audiol, 2019, 30(1): 41-53. doi:10.3766/jaaa.17081.
[8] Ayub A, Qi L, Nunez DA. A systematic review and meta-analysis of extratympanic electrocochleography in Ménières disease diagnosis[J]. Int J Audiol, 2019, 58(9): 533-540. doi:10.1080/14992027.2019.1606947.
[9] Bernaerts A, Vanspauwen R, Blaivie C, et al. The value of four stage vestibular Hydrops grading and asymmetric perilymphatic enhancement in the diagnosis of Menières disease on MRI[J]. Neuroradiology, 2019, 61(4): 421-429. doi:10.1007/s00234-019-02155-7.
[10] Oh KH, Kim KW, Chang J, et al. Can we use electrocochleography as a clinical tool in the diagnosis of Menieres disease during the early symptomatic period?[J]. Acta Otolaryngol, 2014, 134(8): 771-775. doi:10.3109/00016489.2014.907500.
[11] Mammarella F, Zelli M, Varakliotis T, et al. Is electrocochleography still helpful in early diagnosis of meniere disease?[J]. J Audiol Otol, 2017, 21(2): 72-76. doi:10.7874/jao.2017.21.2.72.
[12] Lamounier P, de Souza TSA, Gobbo DA, et al. Evaluation of vestibular evoked myogenic potentials(VEMP)and electrocochleography for the diagnosis of Ménières disease[J]. Braz J Otorhinolaryngol, 2017, 83(4): 394-403. doi:10.1016/j.bjorl.2016.04.021.
[13] Obeidat FS, Lewis Bell S. Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of Menieres disease[J]. Int J Audiol, 2019, 58(11): 738-746. doi: 10.1080/14992027.2019.1627008.
[14] 许珉, 陈耔辰, 魏馨雨, 等. 前庭诱发肌源性电位、冷热试验和耳蜗电图在梅尼埃病诊断中的评估价值[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(8): 704-708. doi: 10.13201/j.issn.1001-1781.2019.08.006. XU Min, Chen Zichen, WEI Xinyu, et al. Evaluation of vestibular evoked myogenic potential, caloric test and cochlear electrogram in the diagnosis of Menieres disease[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, 33(8):704-708. doi: 10.13201/j.issn.1001-1781.2019.08.006.
[15] Zakaria MN, Nik Othman NA, Musa Z. Electrocochleographic recording in Asian adults: Preliminary normative data and demographic analyses[J]. J Otol, 2017, 12(1): 29-33. doi:10.1016/j.joto.2017.02.002.
[16] Grasel SS, de Oliveira Beck RM, Loureiro RSC, et al. Normative data for TM electrocochleography measures[J]. J Otol, 2017, 12(2): 68-73. doi:10.1016/j.joto.2017.04.005.
[17] Bramhall NF, Konrad-Martin D, McMillan GP, et al. Auditory brainstem response altered in humans with noise exposure despite normal outer hair cell function[J]. Ear Hear, 2017, 38(1): e1-e12. doi:10.1097/aud.0000000000000370.
[18] Gerenton G, Giraudet F, Djennaoui I, et al. Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in Menières disease[J]. Hear Res, 2015, 327: 199-208. doi:10.1016/j.heares.2015.07.016.
[19] Redondo-Martínez J, Morant-Ventura A, Robledo-Aguayo D, et al. Extra-tympanic electrocochleography in a normal population. A descriptive study[J]. Acta Otorrinolaringologica Engl Ed, 2016, 67(5): 254-260. doi:10.1016/j.otoeng.2015.10.001.
[20] Hornibrook J. Tone burst electrocochleography for the diagnosis of clinically certain Menieres disease[J]. Front Neurosci, 2017, 11: 301. doi:10.3389/fnins.2017.00301.
[21] 王蕊, 单希征, 王恩彤, 等. 梅尼埃病耳蜗电图特征分析[J]. 北京医学, 2017, 39(8): 796-798. doi:10.15932/j.0253-9713.2017.08.013. WANG Rui, SHAN Xizheng, WANG Entong, et al. Characteristics of electrocochleography in Menieres disease[J]. Beijing Medical Journal, 2017, 39(8): 796-798. doi:10.15932/j.0253-9713.2017.08.013.
[22] Cebulla M, Stürzebecher E, Elberling C, et al. New clicklike stimuli for hearing testing[J]. J Am Acad Audiol, 2007, 18(9): 725-738. doi:10.3766/jaaa.18.9.2.
[23] Wu H. Endolymphatic Hydrops detected by 3-dimensional fluid-attenuated inversion recovery MRI following intratympanic injection of gadolinium in the asymptomatic contralateral ears of patients with unilateral ménières disease[J]. Med Sci Monit, 2015, 21: 701-707. doi:10.12659/msm.892383.
[24] 黄巧,尹时华. 内耳上皮钠通道、水通道蛋白与内淋巴代谢相关性的研究进展[J]. 山东大学耳鼻喉眼学报,2019, 33(4): 145-148. doi:10.6040/j.issn.1673-3770.0.2018.301. Huang Qiao YS. 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. doi:10.6040/j.issn.1673-3770.0.2018.301.
[25] Li W, Lei Y, Zhu J, et al. Signs of electrocochleography on endolymphatic sac decompression for patients with Menieres Disease: Our experience in 12 patients[J]. Clin Otolaryngol, 2018, 43(3): 920-923. doi: 10.1111/coa.13047.
[1] LI Mengxin, XU Hui, ZHANG Xiaoling, XUE Qing, JI Shuangyu, LI Yingying, CUI Limei,. Glucocorticoids alleviate endolymphatic hydrops induced by arginine vasopressin by downregulating aquaporin-2 [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2026, 40(3): 1-6.
[2] 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.
[3] . 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.
[4] 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.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!