Claes Gerd M E, Wyndaele Michel, De Valck Claudia F J, Claes Jos, Govaerts Paul, Wuyts Floris L, Van de Heyning Paul H
University of Antwerp, University Hospital of Antwerp, ENT Department, Wilrijkstraat 10, 2650 Edegem, Belgium.
Eur Arch Otorhinolaryngol. 2008 May;265(5):517-23. doi: 10.1007/s00405-007-0486-7. Epub 2008 Jan 3.
Transtympanic Electrocochleography (TT-ECoG) and the glycerol test can aid in the diagnostic process of Ménière's disease (MD). Measurement of travelling wave velocity (TWV) has been proposed as an alternative to TT-ECoG to detect endolymphatic hydrops. We assessed the feasibility and obtained normative data of the TWV test in the diagnosis of MD, and compared the test results in MD patients with their symptoms and their TT-ECoG results. The TWV test records two runs of auditory brainstem responses to clicks that are ipsilaterally masked with two different high pass filtered noise bands. The resulting latency difference of peak V was used as a measure of the TWV. The 95% confidence interval of this latency difference was defined in a group of 28 normals. Subsequently, the test was performed in nine MD patients. After the TWV test, seven of these patients underwent a TT-ECoG. The symptoms of MD patients at the time of testing and their TT-ECoG results were compared with TWV test results. The 95% confidence interval of the latency difference of peak V in the control group was 0.190-0.668 ms. A latency difference <0.190 ms indicates an increase in TWV, and thus reflects a positive test. In nine MD patients, we found a clear correlation between the result of the TWV test and TT-ECoG. The TWV test result did not significantly correlate with a single symptom. Our findings suggest that the TWV test can be useful to detect endolymphatic hydrops, but further experiments with larger patient groups are needed to confirm the diagnostic value of the TWV test.
经鼓膜电耳蜗图（TT - ECoG）和甘油试验有助于梅尼埃病（MD）的诊断过程。行波速度（TWV）测量已被提议作为检测内淋巴积水的TT - ECoG替代方法。我们评估了TWV测试在MD诊断中的可行性并获得了其正常数据，还比较了MD患者的测试结果与其症状及TT - ECoG结果。TWV测试记录对同侧用两个不同高通滤波噪声带掩蔽的咔嗒声的两次听觉脑干反应。由此产生的V波峰潜伏期差异用作TWV的测量指标。在28名正常人群中定义了该潜伏期差异的95%置信区间。随后，对9名MD患者进行了该测试。在TWV测试后，其中7名患者接受了TT - ECoG检查。将MD患者测试时的症状及其TT - ECoG结果与TWV测试结果进行比较。对照组中V波峰潜伏期差异的95%置信区间为0.190 - 0.668毫秒。潜伏期差异<0.190毫秒表明TWV增加，从而反映测试阳性。在9名MD患者中，我们发现TWV测试结果与TT - ECoG之间存在明显相关性。TWV测试结果与单一症状无显著相关性。我们的研究结果表明，TWV测试可用于检测内淋巴积水，但需要更大患者群体的进一步实验来证实TWV测试的诊断价值。
