A Diagnostic Test for Ménière's Disease and Cochlear Hydrops: Impaired High-Pass Noise Masking of Auditory Brainstem Responses

Don, Manuel; Kwong, Betty; Tanaka, Chiemi

doi:10.1097/01.mao.0000169042.25734.97

Cited by 66 publications

(102 citation statements)

References 34 publications

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“…Another parameter of this test, in addition to wave V latency, is the complex amplitude ratio (CAR). An abnormal CAR value (CAR value below 0.95) has been suggested to have 95% specificity and 90% sensitivity (24,25). It is claimed that the CHAMP test can demonstrate not only the presence of active MD but also the progress of the disease in treatment and follow-up periods.…”

Section: Brainstem Auditory-evoked Potentialsmentioning

confidence: 99%

“…Prolonged latency, decreased amplitude or complete disappearance of the wave I, prolonged latencies between waves, or impaired wave morphology are the typical findings observed in cochlear pathologies, but they are valuable for MD only in the differential diagnosis of retrocochlear pathologies (23). For the diagnoses of EH and MD, an ABR technique called "cochlear hydrops analysis masking procedure" (CHAMP) has been introduced (24). The CHAMP test is the measurement of the difference between the wave V latency obtained with a single-click stimulus and the wave V latency obtained in the presence of a masking noise at 0.5 kHz frequency in addition to a click stimulus.…”

Section: Brainstem Auditory-evoked Potentialsmentioning

confidence: 99%

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Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Günerı

Çakır

Mutlu

2016

Turk Arch Otorhinolaryngol

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Ménière's disease is defined as an idiopathic syndrome characterized by endolymphatic hydrops. Various tests and measurement methods have been employed for the diagnosis of Ménière's disease. These include audiological, vestibular, radiological, clinical, and biochemical tests. However, the lack of a definitive or gold standard diagnostic test sometimes complicates the process of diagnosis. Hence, the clinician should be well-experienced in deciding when to perform a test and how to interpret the results of the test. Furthermore, having the knowledge of the validity and reliability of these tests plays a critical role. This review particularly emphasizes on remarking the validity and reliability of each test performed for the diagnosis of Ménière's disease and discussing the results according to the up-to-date literature.

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Section: Brainstem Auditory-evoked Potentialsmentioning

confidence: 99%

Section: Brainstem Auditory-evoked Potentialsmentioning

confidence: 99%

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Günerı

Çakır

Mutlu

2016

Turk Arch Otorhinolaryngol

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“…This is an auditory brainstem response (ABR) test that is masked with high-pass noise. MD patients display a shortened latency in Wave V. A Californian group has been able to show with 100% sensitivity and 100% specificity a difference between controls and active MD patients displaying at least three of the four core symptoms [12]. However, later studies have failed to repeat such impressive results.…”

Section: Electronystagmographymentioning

confidence: 86%

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

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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...

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“…Don et al conducted the test in 23 definite MD patients and compared the results with 38 non-MD normal-hearing subjects. Their measures did not demonstrate an overlap between the Ménière's and nonMénière's groups, and therefore, the authors concluded that the test had an extremely high, even 100%, sensitivity and 100% specificity for diagnostic use in individual patients [34].…”

Section: Electrophysiology Inmentioning

confidence: 99%

“…The latency delay in normal-hearing ears, between wave V for the click alone response and the 0.5 kHz high-pass masking noise condition, is significantly longer than that in MD ears. This difference is known as the latency delay [34].…”

Section: Cochlear Hydrops Analysis Masking Procedures (Champ)mentioning

confidence: 99%

Electrophysiology in Ménière’s Disease

Lamounier¹

2017

Up to Date on Meniere's Disease

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Ménière's disease (MD) is a progressive inner ear disorder that affects at least 0.2% of the population in EUA. The symptoms triad of fluctuating hearing loss, tinnitus, and vertigo was described by Prosper Ménière for more than a century and its pathophysiology is still unknown. MD has a fluctuating course and in many cases, difficult clinical management. Progressive hearing loss and intense dizzying seizures becomes more frequent as the disease progresses. All of this increases the challenges of accurate identification and has probably led to the trial of several tests for identifying MD. The tests are useful tools to assist the otolaryngologist both in diagnosis and prognosis of MD. These tests includes audiometry, otoacustic emission (OAE), electrocochleography (EcochG), vestibular evoked myogenic potentials (VEMP), cochlear hydrops analysis masking procedure (CHAMP) and video head impulse test (vHIT).

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A Diagnostic Test for Ménière's Disease and Cochlear Hydrops: Impaired High-Pass Noise Masking of Auditory Brainstem Responses

Abstract: This test is able to distinguish objectively active Ménière's disease in individuals and may show promise for tracking changes in the severity of the disease caused by progression or treatment.

Cited by 66 publications

References 34 publications

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

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

Electrophysiology in Ménière’s Disease

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