Auditory Threshold Shifts After Glycerol Administration to Patients With Suspected Menière’s Disease

Basel, Türker; Lütkenhöner, Bernd

doi:10.1097/aud.0b013e31826d0c08

Cited by 14 publications

(23 citation statements)

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“…Efects include a decrease of the summating potential amplitude [33]; (iii) through OAEs, in particular with an improvement of the DPOAEs amplitude [19]. Overall, the data in the literature [19,20,29,32] suggest that DPOAEs can monitor successfully how glycerol recovers the hearing threshold, compromised by the presence of hydrops.…”

Section: Dpoaes and MDmentioning

confidence: 76%

“…At the beginning, the MD hearing loss is typically luctuating, relecting the inner ear hydrops phase: only during this phase, it is possible to perform an osmotic test (Glycerol test) and to observe the improvement of 10 dB in the hearing threshold, at least on two frequencies between 500 Hz and 2000 Hz, within 3 hours, after the administration of 1.5 ml/Kg of body weight of oral glycerol (a potent osmotic agent) with the same volume of isotonic saline solution [19,20]. The glycerol test is not a diagnostic evaluation, but it allows in determining the reversibility of the early phase of MD and, therefore, it has a prognostic and therapeutic signiicance.…”

Section: A Short Introduction Of Ménière's Disease (Md)mentioning

confidence: 99%

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OAEs and Meniere Disease

Hatzopoulos¹,

Ciorba²,

Corazzi³

et al. 2017

Up to Date on Meniere's Disease

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Otoacoustic emissions (OAEs) are responses originating from the inner ear. Clinically they are evoked by diferent families of acoustic stimuli, such as transient acoustic clicks, tone pips, and pure tones. Upon stimulation, the acoustic energy is transformed in the middle ear at acoustic pressure acting upon the stapes footplate. The pressure wave inside the cochlea stimulates the OAE generators and a reverse acoustic energy (the OAE response) propagates from the inner ear, through the stapes and the middle ear structures, to the tympanic membrane. Considering that the acoustic energy has to cross the middle ear structures twice, the functional status of the middle ear can inluence or atenuate considerably the OAE response. In this context, any vestibular alteration can inluence the middle ear mechanics (mainly the middle ear impedance) and consequently the OAE response characteristics. The data in the literature indicate that OAEs are very sensitive to changes in the intracranial pressure. These pressure alterations during the Meniere's hydrops phase are expressed as changes in the intralabyrinthine pressure. Other studies have presented data supporting the assumption that OAEs can adequately monitor middle ear changes induced by the presentation of the glycerol test. The data in the literature suggest that OAEs can monitor the progress of Meniere's disease using reliable indices.

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Section: Dpoaes and MDmentioning

confidence: 76%

Section: A Short Introduction Of Ménière's Disease (Md)mentioning

confidence: 99%

OAEs and Meniere Disease

Hatzopoulos¹,

Ciorba²,

Corazzi³

et al. 2017

Up to Date on Meniere's Disease

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“…The same data as in our previous study [ 20 ], now available from a Digital Repository [ 22 ], are used. Briefly, archived audiograms from 347 patients that underwent a glycerol test to confirm a suspected Menière’s disease were transcribed into a computer-readable form.…”

Section: Methodsmentioning

confidence: 99%

“…Several variants of the glycerol test have been proposed since its first description, and so it seems timely to scrutinize the conceptual and methodological details of the test. In a previous article [ 20 ], we presented a retrospective study of 356 cases with suspected Menière’s disease (all ears fulfilled the aforementioned criteria for definite or at least probable Menière’s disease). In addition to descriptive analyses of the data, we introduced a new criterion for a positive test result.…”

Section: Introductionmentioning

confidence: 99%

Reappraisal of the glycerol test in patients with suspected Menière’s disease

Lütkenhöner

Basel

2014

BMC Ear Nose Throat Disord

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BackgroundRecent advances in magnetic resonance imaging make it possible to visualize the presumed pathophysiologic correlate of Menière’s disease: endolymphatic hydrops. As traditional diagnostic tests can provide only indirect evidence, they are hardly competitive in this respect and need to be rethought. This is done here for the glycerol test.MethodsThe data of a previous retrospective analysis of the glycerol test in patients with suspected Menière’s disease are reinterpreted using a simple model. The mean threshold reduction (MTR) in the frequency range from 125 to 1500 Hz (calculated from audiograms obtained immediately before and four hours after the glycerol intake) is used as the test statistic. The proposed model explains the frequency distribution of the observed MTR by the convolution of a Gaussian probability density function (representing measurement errors) with a template representing the frequency distribution of the true MTR. The latter is defined in terms of two adjustable parameters. After fitting the model to the data, the performance of the test is evaluated using receiver operating characteristic (ROC) analysis.ResultsThe cumulative frequency distribution of the observed MTR can be explained almost perfectly by the model. According to the ROC analysis performed, the capability of the currently used audiometric procedure to detect a glycerol-induced threshold reduction corresponds to a diagnostic test of rather high accuracy (area under the ROC curve greater than 0.9). Simulations show that methodological improvements could further enhance the performance.ConclusionsOwing to their ability to reveal functional aspects without an obvious morphological correlate, traditional test for Menière’s disease could be decisive for defining the stage of the disease. A distinctive feature of the glycerol test is that it is capable of determining, with high accuracy, whether the pathophysiologic condition of the inner ear is partially reversible. Prospectively, this could help to estimate the chances of specific therapies.

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“…The glycerol test, a modification of the ECoG, was proposed as a way of improving diagnostic accuracy of the audiogram and ECoG by challenging inner ear fluid homeostasis. However, studies show only about a 50 % incidence of glycerol-induced threshold shift (a ''positive'' test) in Meniere patients [62,63]. The combination of low sensitivity and significant patient discomfort in performance of the test have led to its abandonment at most centers.…”

Section: Electrocochleography (Ecog)mentioning

confidence: 99%

Electrophysiologic Diagnosis of Meniere’s Disease

Tilburg

Rauch

2014

Curr Otorhinolaryngol Rep

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Meniere's disease was first described in 1861 by Prosper Meniere. The exact pathophysiology is still unclear. The history taken by the physician in combination with audiometric testing are still the most important diagnostic tools, however multiple electrophysiological tests have been described to aid in the diagnosis of Meniere's disease. These tests are used because of their presumed sensitivity to structural and/or electrochemical changes brought about by endolymphatic hydrops, although the precise relationship between hydrops and the symptoms of Meniere's disease is still uncertain. Here we discuss the electrophysiologic tests that are currently used clinically in Meniere's disease, namely vestibular evoked myogenic potentials, electrocochleography, and the cochlear hydrops analysis masking procedure. At the current state-of-the-art, results of these tests must be considered corroborative rather than diagnostic.

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Auditory Threshold Shifts After Glycerol Administration to Patients With Suspected Menière’s Disease

Abstract: If the pretest audiogram does not render a positive test result unlikely, a state-of-the-art implementation of the glycerol test is a competitive method for corroborating a suspected diagnosis of Menière's disease.

Cited by 14 publications

References 0 publications

OAEs and Meniere Disease

OAEs and Meniere Disease

Reappraisal of the glycerol test in patients with suspected Menière’s disease

Electrophysiologic Diagnosis of Meniere’s Disease

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