Utility of Area Curve Ratio Electrocochleography in Early Meniere Disease

Devaiah, Anand K.; Dawson, Kristen L.; Ferraro, John A.; Ator, Gregory A.

doi:10.1001/archotol.129.5.547

Cited by 46 publications

(37 citation statements)

References 14 publications

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“…For instance, if the patient has severe hearing loss, it can be difficult to observe the waves (33). If the patient is not in an acute attack stage, the sensitivity decreases to 60% (34). Because ECoG has low sensitivity in patients with insignificant symptoms, it can lead to some problems in the diagnosis of possible or probable MD (33).…”

Section: Ecogmentioning

confidence: 99%

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Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Günerı

Çakır

Mutlu

2016

Turk Arch Otorhinolaryngol

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Ménière's disease is defined as an idiopathic syndrome characterized by endolymphatic hydrops. Various tests and measurement methods have been employed for the diagnosis of Ménière's disease. These include audiological, vestibular, radiological, clinical, and biochemical tests. However, the lack of a definitive or gold standard diagnostic test sometimes complicates the process of diagnosis. Hence, the clinician should be well-experienced in deciding when to perform a test and how to interpret the results of the test. Furthermore, having the knowledge of the validity and reliability of these tests plays a critical role. This review particularly emphasizes on remarking the validity and reliability of each test performed for the diagnosis of Ménière's disease and discussing the results according to the up-to-date literature.

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Section: Ecogmentioning

confidence: 99%

“…The SP/AP curve area ratio, one of these parameters, has a higher sensitivity, particularly in early-stage MD (34). In another parameter, stimulus biasing ratio carries the sensitivity of ECoG up to 85% (35).…”

Section: Ecogmentioning

confidence: 99%

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Günerı

Çakır

Mutlu

2016

Turk Arch Otorhinolaryngol

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“…Therefore, various attempts have been made to improve the sensitivity of ECoG in the diagnosis of MD. For example, the width of the SP-AP waveform [1] , the SP/ AP area ratio [2] , the 1-kHz burst-evoked SP amplitude [3] and AP latency difference to condensation and rarefaction clicks [4] as well as the SP/AP amplitude ratio are introduced as an efficient diagnostic indicator of ECoG. As to the recording technique, the transtympanic technique was introduced to yield a good output and signalto-noise ratio in addition to the less invasive extratympanic and tympanic techniques.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

Takeda

Kakigi

2010

ORL

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Objective: To evaluate the clinical conditions causing an elevation in the click-evoked summation potential (SP)/action potential (AP) amplitude ratio (SP/AP ratio), the cause of the SP enhancement in Ménière’s disease (MD) and the diagnostic efficacy of electrocochleography (ECoG) were discussed. Study Design: Retrospective case review. Setting: An outpatient clinic of the Otolaryngology Department of Kochi Medical School. Patients: ECoG testing was performed in 632 patients (727 ears) with vertigo/dizziness and/or deafness over a 10-year period (1995–2005). Among them, 334 patients had diagnoses of definite MD, including 95 cases of bilateral involvement. Main Outcome Measures: Audiological thresholds and SP/AP ratio. Results: An enhanced SP was observed in 56.3% of patients with MD. The incidence of an enhanced SP was low in patients for whom the disease duration was 2 years or less and the frequency of attacks was once a year or less, but was significantly higher in cases where the disease duration was 2 years or longer and/or the frequency of attacks was several times a year (Games-Howell test, p < 0.05). The incidence of an enhanced SP was significantly elevated in cases with pure-tone average exceeding 31 dB (Kendall’s rank correlation test, p < 0.001). However, the enhanced SP, once it appeared, did not always disappear in spite of hearing improvement. Hearing improvement induced by the glycerol test also produced no alteration in an SP/AP ratio, and there was no significant difference between the glycerol test results and the incidence of an enhanced SP (χ² goodness-of-fit test). Conclusions: The longer the patients were symptomatic or the severer the ear symptoms, the more likely the ECoG was to be positive. The abnormally elevated SP, once it had appeared, persisted for long periods. Spontaneous and glycerol-induced hearing gains did not result in a decrease in SP/AP ratio. These clinical characteristics of ECoG seem to indicate that the enhanced SP in MD might be caused by the malfunction of hair cells, not by the displacement of the basilar membrane toward the scala tympani.

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“…The analysis of the variable area was included in our study since it also represents a good parameter of interpretation of nerve conduction studies. The calculation of the SP/AP area ratio, described in some studies 11,12 and used in the present study, stands out as a very sensitive test to assess cochlear response to hearing stimulus in Ménière's disease, as well as in situations in which the cochlea is at risk due to surgical injury 13 . Since SP/AP area ratio is the integral of a function of the combination between amplitude and duration of action potential, Riemann integral reflects the number and synchronism of activated nerve fibers.…”

Section: Discussionmentioning

confidence: 99%

Avaliação dos potenciais evocados cocleares após lesão do utrículo por eletrocauterização

Maia¹,

Dolganov²,

Lavinsky³

2012

Braz. j. otorhinolaryngol.

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Ut riculostomy is a new surgical alternative for Ménière's disease. The basis of this procedure is that the outcome of an electrocautery-induced utricular trauma does not affect cochlear function. However, a demonstration of the hypothesis that this approach to the utricle would preserve hearing is still pending.Objective: To determine whether any changes would occur in the electrical potentials evoked in the cochlea and auditory nerve before, during, and 1 month after a surgical procedure in the utricule in an animal model. Materials and Methods:An experimental study. Eight sheep underwent electrocautery-induced utricular trauma, and their cochlear function was assessed by electrocochleography -recording of electrical evoked potentials, in the preoperative, immediate postoperative and medium-term postoperative periods. The results were analyzed statistically.Results: There were no statistically significant variations in amplitude (p = 0.099) and latency (p = 0.591) before and 1 month after the surgical procedure. There was a statistically significant change in the summation of the potential/action potential area ratio (p = 0.0122), a calculated loss of 11.8 dB. Conclusion:The intervention performed in this study enabled us to conclude that, taking into account the impaired electrophysiological responses observed during and 1 month after the surgical procedure, hearing was preserved in the operated sheep. ORIGINAL ARTICLEBraz J Otorhinolaryngol. 2012;78(2):52-8.

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Utility of Area Curve Ratio Electrocochleography in Early Meniere Disease

Abstract: The SP/AP area curve ratio significantly improves ECochG diagnostic sensitivity in possible MD. This ECochG refinement will allow earlier intervention to preserve inner ear function in MD.

Cited by 46 publications

References 14 publications

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

Validity and Reliability of the Diagnostic Tests for Ménière's Disease

The Clinical Value of Extratympanic Electrocochleography in the Diagnosis of Ménière’s Disease

Avaliação dos potenciais evocados cocleares após lesão do utrículo por eletrocauterização

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