Detection of Saccular Endolymphatic Hydrops in Ménière's Disease Using a Modified Glycerol cVEMP Test in Combination With the Tuning Property Test

Abstract

The tuning property test is an easy and useful way of detecting saccular EH. However, the glycerol cVEMP test is required in patients that do not respond to either 500 or 1000 Hz short tone bursts (STB).

Is Alteration of Tuning Property in Cervical Vestibular-Evoked Myogenic Potential Specific for Ménière’s Disease?

“…MR imaging requires high costs and is currently used in a research setting (3). Therefore, the physiological confirmation of EH is still useful for diagnosis of EH in MD (4). For detection of EH in the cochlea, electrocochleography (5) and glycerol test using improvement of pure-tone hearing as an index (6) have been used, while for detection of EH in the semicircular canal, furosemide test has been used (7).…”

“…The one is the glycerol cervical vestibular-evoked myogenic potential (cVEMP) test, and the other is the tuning property test of cVEMP (4). Traditionally, glycerol has been used for the test of EH in the cochlea because glycerol temporally reduces EH in the inner ear (6).…”

“…Then, improvement of pure-tone hearing after glycerol administration was regarded as a sign suggestive of EH in the cochlea. Recently, glycerol administration has been applied to cVEMP test, a test of functions of the saccule, to detect EH in the saccule (4). As glycerol cVEMP test, improvement of cVEMP responses was assessed after intravenous infusion of 10% glycerol (500 ml, 2 h) (4).…”

“…Recently, glycerol administration has been applied to cVEMP test, a test of functions of the saccule, to detect EH in the saccule (4). As glycerol cVEMP test, improvement of cVEMP responses was assessed after intravenous infusion of 10% glycerol (500 ml, 2 h) (4). The positivity rate (PR) of glycerol cVEMP test was 60% (12/20) in definite MD patients when significant improvement of cVEMP amplitude (p13–n23) was adopted as an index.…”

“…Murofushi et al calculated 500–1,000 Hz cVEMP slope to quantify this frequency preference (see Methods in this article) (11). According to Murofushi et al (4), PR of tuning property test in definite MD ears was 69% (11/16) when totally cVEMP-absent patients were excluded. In that study, the cutoff point was set using mean − 2SD of the healthy subjects.…”