The Use of Electrocochleography in the Diagnosis, Assessment, and Monitoring of Endolymphatic Hydrops

Ferraro, John A.; Lg, Best; Ik, Arenberg

doi:10.1016/s0030-6665(20)32093-4

Cited by 47 publications

(9 citation statements)

References 12 publications

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“…There was a flat or high tone hearing loss in 84 per cent of all patients and all those with severe loss (Type 3) had this audiometric configuration. These findings are consistent with studies reported by Ferraro et al (1983) and Campbell et al (1992b).…”

Section: Discussionsupporting

confidence: 94%

Effect of hearing loss in electrocochleographic investigation of endolymphatic hydrops using tone-pip and click stimuli

1994

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Extratympanic electrocochleography (ECochG) was performed on 37 patients referred to the Evoked Potential Clinic with suspected Ménière's disease. The patients were classified according to their hearing impairment and audiometric configuration. Click and tone-pip stimuli with tone frequencies of 1 and 4 kHz were presented at a rate of 10 per second. Amplitude, latency and general waveform characteristics of the summation potential (SP) and action potential (AP) were analysed for each averaged response with respect to the level and configuration of the hearing loss. The highest incidence of abnormal percentage SP was in patients with average hearing loss in the range of 40–64 dB HL using the click stimulus. In low tone hearing loss, hydrops was identified from an enhanced SP in significantly more patients using the click and 4 kHz tone-pip than the 1 kHz stimulus. Measurement of the width of the 1 kHz tone-pip response waveform was abnormal in some patients even though the click and 4 kHz responses were normal. The optimum stimulus for identification of hydrops from an enhanced SP is dependent on the level and configuration of the hearing loss.

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Section: Discussionsupporting

confidence: 94%

Effect of hearing loss in electrocochleographic investigation of endolymphatic hydrops using tone-pip and click stimuli

1994

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“…ECochG has been historically a test used for the assessment of endolymphatic hydrops, associated with Ménière's disease. [ 8 9 10 17 ] Only recently has ECochG been studied in cases of SCDS. The SP/AP ratio is commonly elevated, and often decreases after surgical plugging of the superior semicircular canal.…”

Section: Discussionmentioning

confidence: 99%

“…Electrocochleography (ECochG) is an electrophysiologic test used for the diagnosis of endolymphatic hydrops, especially as seen in Ménière's disease. [ 8 9 15 17 ] Patients with SCDS have recently also been found to have an elevated summating potential to action potential (SP/AP) ratio, as measured by ECochG,[ 2 ] and this abnormal ratio appears to often correct after surgery for plugging the dehiscent semicircular canal. [ 1 14 22 ] Intraoperative monitoring procedures such as ECochG or auditory brainstem responses (ABR) are commonly used during vestibular schwannoma surgery.…”

Section: Introductionmentioning

confidence: 99%

Electrocochleography summating potential seen on auditory brainstem response in a case of superior semicircular canal dehiscence

Ward

Wenzel

Ritzl³

et al. 2017

Surg Neurol Int

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Background:Superior canal dehiscence syndrome (SCDS) is a condition in which an abnormal communication between the superior semicircular canal and the middle cranial fossa causes patients to hear internal noises transmitted loudly to their affected ear as well as to experience vertigo with pressure changes or loud sounds. Patients with SCDS can have an elevated ratio of summating potential (SP) to action potential (AP) as measured by electrocochleography (ECochG). Changes in this ratio have been observed during surgical intervention to correct this abnormal communication.Case Description:We present a case of SCDS along with history, physical examination, vestibular function testing, and computed tomography imaging. Due to the disabling symptoms, the patient elected to undergo surgery for plugging of the superior semicircular canal by middle cranial fossa approach. Simultaneous intraoperative ECochG and auditory brainstem response (ABR) were performed. Changes in SP/AP ratio, SP amplitude, and ABR wave I latency were observed during surgery, with a large ECochG SP amplitude generating a new wave, identifiable on the ABR and preceding the traditional wave I. The patient's symptoms resolved after surgery, and no long-term detriment to hearing was observed.Conclusions:This case demonstrates the intraoperative changes in ECochG during surgery for repair of a SCDS. The substantial intraoperative changes in the summating potential can create a novel wave on intraoperative ABR.

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“…The band-pass filter was set to 3–3,000 Hz; a high pass filter of 3 Hz was used because the SP, as a direct current potential, is particularly sensitive to high pass filter settings. The use of a high pass filter of 3 Hz, is thought to minimize the distortion present in the SP signal (Ferraro et al, 1983 ).…”

Section: Methodsmentioning

confidence: 99%

Human Summating Potential Using Continuous Loop Averaging Deconvolution: Response Amplitudes Vary with Tone Burst Repetition Rate and Duration

et al. 2017

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Electrocochleography (ECochG) to high repetition rate tone bursts may have advantages over ECochG to clicks with standard slow rates. Tone burst stimuli presented at a high repetition rate may enhance summating potential (SP) measurements by reducing neural contributions resulting from neural adaptation to high stimulus repetition rates. To allow for the analysis of the complex ECochG responses to high rates, we deconvolved responses using the Continuous Loop Averaging Deconvolution (CLAD) technique. We examined the effect of high stimulus repetition rate and stimulus duration on SP amplitude measurements made with extratympanic ECochG to tone bursts in 20 adult females with normal hearing. We used 500 and 2,000 Hz tone bursts of various stimulus durations (12, 6, 3 ms) and repetition rates (five rates ranging from 7.1 to 234.38/s). A within-subject repeated measures (rate x duration) analysis of variance was conducted. We found that, for both 500 and 2,000 Hz stimuli, the mean deconvolved SP amplitudes were larger at faster repetition rates (58.59 and 97.66/s) compared to slower repetition rates (7.1 and 19.53/s), and larger at shorter stimulus duration compared longer stimulus duration. Our concluding hypothesis is that large SP amplitude to short duration stimuli may originate primarily from neural excitation, and large SP amplitudes to long duration, fast repetition rate stimuli may originate from hair cell responses. While the hair cell or neural origins of the SP to various stimulus parameters remains to be validated, our results nevertheless provide normative data as a step toward applying the CLAD technique to understanding diseased ears.

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The Use of Electrocochleography in the Diagnosis, Assessment, and Monitoring of Endolymphatic Hydrops

Cited by 47 publications

References 12 publications

Effect of hearing loss in electrocochleographic investigation of endolymphatic hydrops using tone-pip and click stimuli

Effect of hearing loss in electrocochleographic investigation of endolymphatic hydrops using tone-pip and click stimuli

Electrocochleography summating potential seen on auditory brainstem response in a case of superior semicircular canal dehiscence

Human Summating Potential Using Continuous Loop Averaging Deconvolution: Response Amplitudes Vary with Tone Burst Repetition Rate and Duration

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