Electrocochleography in the Evaluation of Patients with Ménière's Disease/Endolymphatic Hydrops

Ferraro, John A.; Durrant, John D.

doi:10.3766/jaaa.17.1.6

Cited by 96 publications

(86 citation statements)

References 60 publications

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“…The full audiological and radiological protocol performed allowed to identify separately both cochlear and retrocochlear disorders, although the diagnosis of ELH was not confirmed by imaging due to unavailability of 3-Tesla MRI (the availability of 3-Tesla scanners is still limited in many hospitals) or, as suggested by some authors, electrocochleography 30 ; consequently, ELH diagnosis was only based on symptoms reported by the patient over the years associated to the results of the auditory and vestibular evaluation performed initially and during follow up and to patient's response to therapy.…”

Section: Discussionmentioning

confidence: 99%

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Ralli

Greco

Altissimi

et al. 2017

The International Tinnitus Journal

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Vestibular schwannoma and endolymphatic hydrops are two conditions that may present with similar audio-vestibular symptoms. The association of the two in the same patient represents an unusual finding that may lead clinicians to errors and delays in diagnosis and clinical management of affected subjects. We discuss the case of a patient with an intrameatal vestibular schwannoma reporting symptoms suggestive for ipsilateral endolymphatic hydrops. The patient presented with fluctuating hearing loss, tinnitus, and acute rotatory vertigo episodes, and underwent a full audiological evaluation and imaging of the brain with contrast-enhanced Magnetic Resonance Imaging. Clinical audio-vestibular and radiological examination confirmed the presence of coexisting vestibular schwannoma and endolymphatic hydrops. Hydrops was treated pharmacologically; vestibular schwannoma was monitored over time with a wait and scan protocol through conventional MRI. The association of vestibular schwannoma and endolymphatic hydrops is rare, but represents a possible finding in clinical practice. It is therefore recommended investigating the presence of inner ear disorders in patients with vestibular schwannoma and, similarly, to exclude the presence of this condition in patients with symptoms typical of inner ear disorders.

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Section: Discussionmentioning

confidence: 99%

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Ralli

Greco

Altissimi

et al. 2017

The International Tinnitus Journal

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“…This last inclusion criterion is based on the studies of Ferraro et al [14] where ECochG was performed using a tympanic electrode.…”

Section: Patientsmentioning

confidence: 99%

“…CM is thus cancelled when using alternating polarity. The SP is generated by the inner hair cells [9,14] , and the AP is generated from the auditory nerve cells (N1) [12] .…”

Section: Introductionmentioning

confidence: 99%

“…An increased SP amplitude ratio is typically interpreted as possible EH. Elevation of the SP/ AP amplitude ratio has been shown to have high specificity (90%), but poor sensitivity (55% to 65%), for the identification of EH [14] . Over the past few years, efforts have been made toward the improvement of ECochG sensitivity.…”

Section: Introductionmentioning

confidence: 99%

“…Over the past few years, efforts have been made toward the improvement of ECochG sensitivity. It has been demonstrated that the use of the SP/AP area ratio when combined with the SP/AP amplitude ratio significantly increases ECochG's sensitivity (92%) without affecting its specificity, which remains as high as 84% [14] .…”

Section: Introductionmentioning

confidence: 99%

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Ear Fullness as a Symptom of Endolymphatic Hydrops in non-Ménière’s Patient

Maheu

Alhabib²,

Landry

et al. 2017

Int Adv Otol

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OBJECTIVE: 1) To determine if unexplained ear fullness might be a symptom of endolymphatic hydrops (EH) by using Electrocochleography (ECochG) SP/AP area and amplitude ratios. 2) To assess if individuals with unexplained ear fullness without vertigo differ significantly from individuals with ear fullness due to Ménière's disease (MD). MATERIALS and METHODS:In a case-control study in our tertiary care center, we evaluated 62 ears across 49 patients, including 18 normal healthy ears across 12 control patients, 26 ears with unexplained ear fullness across 20 patients (6 had bilateral symptoms of ear fullness), and 18 ears with definite MD across 17 patients (1 bilateral disease). Outcome measures were SP/AP amplitude and area ratio, hearing threshold, and air-bone gap. RESULTS:The analysis of auditory thresholds revealed a significant group effect for air conduction [F(2,50)=49.627; p<0.001] and for bone conduction [F(2,50)=45.625; p<0.001]. We observed significant differences between MD (36.36±4.87) and control patients (19.85±2.55) (p=0.015) for amplitude ratio. Moreover, significant differences were noted between MD (5.32±1.06) and controls (1.36±0.07) (p=0.035) and between ear fullness (5.16±1.17) and controls (p=0.026) for the area ratio parameter. No significant correlation was observed between SP/AP area or amplitude ratios and air-bone gap at any of the tested frequencies. The amplitude ratio was not significantly different between the ear fullness and control groups (p=0.406). The area and amplitude ratios did not reveal significant differences between MD and ear fullness (p=1.00). CONCLUSION:EH can be present even in the absence of vertigo and when patients report unexplained ear fullness. This study, to our knowledge, is the first to possibly allow early identification of cochlear EH in patients suffering from ear fullness without vertigo.

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Endolymphatic volume in patients with meniere's disease and healthy controls: Three‐dimensional analysis with magnetic resonance imaging

Ito

Inui

Miyasaka

et al. 2019

Laryngoscope Investig Oto

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ObjectiveRecently, 3‐Tesla magnetic resonance imaging (MRI) with intravenous gadolinium injection has been used to reveal endolymphatic hydrops (EH). In the present study, we aimed to evaluate EH in patients with Meniere's disease (MD) objectively and quantitatively, and compared the endolymphatic space (ELS) in individuals with MD and healthy controls, to gain understanding of the characteristics of MD.MethodsEighty‐two patients with unilateral MD (uMD), 16 patients with bilateral MD (bMD), and 47 healthy volunteers were enrolled. All participants underwent 3‐T MRI at 4 hours after intravenous gadolinium injection. The volumes of the total fluid space (TFS) and ELS were measured semiautomatically using our workstation, and the percentage of ELS to TFS (ELS percentage) was calculated.ResultsThe ELS percentage was 13.9 in the ears of controls, 18.2 in the contralateral ear of individuals with uMD, 26.1 in the affected ears of these individuals, and 23.0 in both ears of individuals with bMD. The ELS percentages in the affected ear of uMD and the ears of bMD individuals were significantly higher than that in the ears of control individuals (P < .01, one‐way analysis of variance (ANOVA), Tukey's test).ConclusionThe ELS is significantly larger in the affected ears of uMD and in both ears of bMD individuals. Accurate diagnosis of MD can be facilitated by using 3‐T MRI 4 hours after intravenous gadolinium injection and performing volumetric measurements of the ELS.Level of Evidence2b

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Electrocochleography in the Evaluation of Patients with Ménière's Disease/Endolymphatic Hydrops

Cited by 96 publications

References 60 publications

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Vestibular Schwannoma and Ipsilateral Endolymphatic Hydrops: An Unusual Association

Ear Fullness as a Symptom of Endolymphatic Hydrops in non-Ménière’s Patient

Endolymphatic volume in patients with meniere's disease and healthy controls: Three‐dimensional analysis with magnetic resonance imaging

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