Conventional analysis of the click-evoked electrocochleogram includes measurement of the amplitudes of the cochlear summating potential (SP) and auditory nerve action potential (AP) to derive the SP/AP amplitude ratio. It is now well documented that an amplitude ratio where SP is elevated relative to AP may be a positive finding for endolymphatic hydrops in patients suspected of having Ménière's disease (MD). However, the incidence of an elevated SP/AP amplitude ratio in the general MD population is only approximately 60%. This relatively low value necessitates efforts to improve the diagnostic sensitivity of electrocochleography (ECochG) for MD. A review of early and more recent literature in this area indicates that consideration of both the amplitude and duration of ECochG components may help to achieve this goal. The present study combined these features to measure the "area" of the SP-AP complex in normal and MD populations. A software routine was used to measure the amplitude x duration area of the SP-AP complex in (a) normally hearing adults with normal SP/AP amplitude ratios (Group 1), (b) confirmed MD patients with elevated SP/AP amplitude ratios (Group 2), and (c) probable MD patients with normal SP/AP amplitude ratios (Group 3). Ninety percent of the confirmed MD patients in Group 2 displayed elevated SP/AP area ratios relative to the normative value established from Group 1. In addition, almost half of the probable MD patients from Group 3 displayed elevated area ratios. These findings indicate that measurement of the SP/AP area ratio holds promise for improving the sensitivity of ECochG in the diagnosis of MD.
Otolaryngology-Head and Neck Surgery August lgO9 racotomy, 6 required neck exploration to remove the FB, but the rest were managed by endoscopic removal of the FB. Conclusion: The major complication rate of foreign bodies in the esophagus was 7.3%. The mortality rate was 0.73%. The longer the FB is impacted in the esophagus the higher the risk of perforation. A leukocyte count of greater than 1010/L is more likely to be associated with a perforation of the esophagus. Most of the major complications can be safely managed by endoscopic removal of the FB.
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