Devaiah Anand K, Dawson Kristen L, Ferraro John A, Ator Gregory A
Departments of Otolaryngology--Head and Neck Surgery, University of Kansas Medical Center, Kansas City, USA.
Arch Otolaryngol Head Neck Surg. 2003 May;129(5):547-51. doi: 10.1001/archotol.129.5.547.
Electrocochleography (ECochG) is useful in supporting the diagnosis of Meniere disease (MD). Possible MD (early disease as defined by the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium) is a readily treatable form of MD.
To identify whether ECochG summating potential/action potential (SP/AP) area curve measures are more sensitive than conventional SP/AP amplitude ratios in detecting possible MD.
A retrospective chart review of a 3-year period (1997-2000) was conducted. All charts of patients diagnosed as having MD who had undergone tympanic ECochG were examined to identify those with possible MD. Exclusion criteria were incomplete workup, ECochG performed using a prior system, cochlear microphonic spike obscuring ratio measurements, and prior otologic surgery. A control group of patients with normal SP/AP ratios and ECochG data were identified. SP/AP amplitude and area curve ratios for both groups were measured.
Of 138 patients with MD reviewed, 20 (14%) had possible MD, and 8 passed exclusion criteria. An audiologist blinded to patients' diagnoses performed all measurements. The upper limit of normal for SP/AP amplitude and area curve ratios from the control group of ears (n = 13) (alpha =.05) were similar to previously published results. Of the 8 patients with possible MD, 4 had an abnormal SP/AP amplitude ratio, and 7 had an abnormal SP/AP area curve ratio; the difference between groups was statistically significant (P =.03, chi2).
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.
电耳蜗图（ECochG）有助于梅尼埃病（MD）的诊断。可能的梅尼埃病（按照1995年美国耳鼻咽喉-头颈外科学会听力与平衡委员会定义的早期疾病）是梅尼埃病一种易于治疗的形式。
确定在检测可能的梅尼埃病时，ECochG总和电位/动作电位（SP/AP）面积曲线测量是否比传统的SP/AP幅度比更敏感。
对3年期间（1997 - 2000年）进行回顾性病历审查。检查所有诊断为梅尼埃病且接受过鼓膜ECochG检查的患者病历，以确定那些患有可能的梅尼埃病的患者。排除标准为检查不完整、使用先前系统进行的ECochG检查、耳蜗微音电位尖峰掩盖率测量以及先前的耳科手术。确定一组SP/AP比率和ECochG数据正常的对照组患者。测量两组的SP/AP幅度和面积曲线比率。
在审查的138例梅尼埃病患者中，20例（14%）患有可能的梅尼埃病，8例通过排除标准。一名对患者诊断不知情的听力学家进行了所有测量。对照组耳朵（n = 13）（α = 0.05）的SP/AP幅度和面积曲线比率的正常上限与先前发表的结果相似。在8例可能患有梅尼埃病的患者中，4例SP/AP幅度比率异常，7例SP/AP面积曲线比率异常；两组之间的差异具有统计学意义（P = 0.03，卡方检验）。
SP/AP面积曲线比率显著提高了ECochG对可能的梅尼埃病的诊断敏感性。这种ECochG的改进将使在梅尼埃病中更早地进行干预以保留内耳功能成为可能。
