Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of Ménière's disease

Lamounier, Pauliana; Souza, Thiago Silva Almeida de; Gobbo, Débora Aparecida; Bahmad, Fayez

doi:10.1016/j.bjorl.2016.04.021

Cited by 17 publications

(20 citation statements)

References 32 publications

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“…In the identified MD cases, both cVEMP and ECochG showed high specificity of 83.3 and 100%, respectively, and low to moderate sensitivity at 22.2 and 71.4%, respectively. This result is consistent with previous findings in the literature, indicating a good ability for cVEMP and ECochG to correctly rule out the disease (Lamounier et al 2017). The sensitivity of cVEMP in the most and least affected ears was 29 and 22.2%, respectively.…”

Section: Discussionsupporting

confidence: 92%

“…The sensitivity of cVEMP in the most and least affected ears was 29 and 22.2%, respectively. This was lower than that found in previous studies, which ranged between 40 and 63.6% (de Waele et al 1999;Lamounier et al 2017;Young, Huang, and Cheng 2003), although they did not use objective methods to define thresholds. The sensitivity of ECochG was 71.4% in the most affected ears and 33% in the least affected ears.…”

Section: Discussioncontrasting

confidence: 66%

“…The sensitivity of ECochG was 71.4% in the most affected ears and 33% in the least affected ears. Previous findings ranged between 57 and 71% (Lamounier et al 2017), so we are in the upper range that has been reported previously. The threshold of SP/AP amplitude ratio used to define abnormality varies in the literature, which leads to variation in the sensitivity and specificity of the ECochG test in the diagnosis of MD.…”

Section: Discussionsupporting

confidence: 61%

“…Although due to the low number of least affected ears in the MD group, this result should be treated with some caution. The agreement between the two tests was not expected to be perfect, because they evaluated different vestibular structures in the inner ear, which was suggested by Lamounier et al (2017).…”

Section: Most Affected Earsmentioning

confidence: 99%

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Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of Ménière’s disease

Obeidat

Bell

2019

International Journal of Audiology

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Objective: To compare the sensitivity and specificity of objective cervical vestibular-evoked myogenic potential (cVEMP) tuning curves and electrocochleography (ECochG) for the diagnosis of M eni ere's disease (MD). Design: Sensitivity and specificity were calculated from 95% normative ranges of 500 Hz cVEMP threshold and ECochG SP/AP amplitude ratios. Measures: Extra-tympanic ECochG testing to 90 dB nHL clicks and cVEMP threshold tuning curves (250-1000 Hz). Study sample: We tested 15 patients (30 ears) diagnosed with definite bilateral MD based on the clinical criteria proposed by the American Academy of Otolaryngology Head and Neck surgery, 1995 (assumed gold standard) and 20 controls. Results: 500 Hz cVEMP threshold was the most promising parameter to differentiate MD ears from controls. cVEMP and ECochG showed high specificity (83.3 and 100%, respectively) and low to moderate sensitivity (22.2 and 71.4%) for long term MD. ECochG sensitivity increased to 89% during a symptomatic period, compared to 33% for cVEMP. However, ECochG can be difficult to schedule during symptomatic periods. Sensitivity of cVEMP for the diagnosis of MD appears limited. Conclusions: ECochG has higher sensitivity than cVEMP in the diagnosis of M eni ere's patients, but the ECochG SP/AP amplitude ratio measure is not perfect for the diagnosis of MD.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 66%

Section: Discussionsupporting

confidence: 61%

Section: Most Affected Earsmentioning

confidence: 99%

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Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of Ménière’s disease

Obeidat

Bell

2019

International Journal of Audiology

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“…The sensitivity of EcochG for the right ear was 63.6% and 37.5% for the left ear. They concluded that the specificity of both tests was high, and the sensitivity of VEMP was higher than that of EcochG [3].…”

Section: Up To Date On Meniere's Diseasementioning

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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Saccular measurements in routine MRI can predict hydrops in Menière’s disease

Simon

Guichard

Kania

et al. 2017

Eur Arch Otorhinolaryngol

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Most patients with suspicion of hydrops do not have access to MRI with 3D reconstruction of the endolymphatic space. Our main objective was to show that measurements of the saccule on a non-enhanced 3D-T2 MRI could show hydrops and help diagnose Menière disease. We conducted a prospective study from 2015 to 2016 to compare consecutive patients consulting for Menière's disease to a control group (patients with unilateral non-hydrops disorders and contralateral healthy ears). They all received full auditory and vestibular testing. They also underwent a 3-Tesla 3D-T2 MRI using CISS sequence (0.4 mm thick slices), which were blindly evaluated by two independent neuroradiologists. The saccular height and width were measured in a coronal plane and Menière's disease patients' symptomatic ears were compared to asymptomatic and control ears. 36 patients with definite Menière's disease and 36 control patients were studied, including 42 symptomatic Menière, 30 asymptomatic Menière and 72 control ears. Saccular measurements were significantly different between symptomatic Menière ears compared to healthy ears (1.59 vs 1.32 mm, p < 0.001 for height; 1.13 vs 0.90 mm, p < 0.001 for width). Symptomatic and asymptomatic Menière ears' measurements were not significantly different (p = 0.307 and p = 0.109). Using ROC curve, we found cut-off values for saccular height 1.51 mm, Se = 63%, Sp = 95% and width 1.05 mm, Se = 41%, Sp = 95%. Routine 3D-T2 MRI, which patients must undergo for differential diagnosis, could help diagnose hydrops with high specificity using saccular measurements.

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Evaluation of vestibular evoked myogenic potentials (VEMP) and electrocochleography for the diagnosis of Ménière's disease

Abstract: The specificity of both tests was high, and the sensitivity of VEMP was higher than that of EcochG.

Cited by 17 publications

References 32 publications

Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of Ménière’s disease

Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of Ménière’s disease

Electrophysiology in Ménière’s Disease

Saccular measurements in routine MRI can predict hydrops in Menière’s disease

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