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耳蜗积水分析掩蔽程序在梅尼埃病中的诊断效率。

Diagnostic efficiency of the cochlear hydrops analysis masking procedure in Ménière's disease.

机构信息

Department of Otorhinolaryngology, College of Medicine, Konyang University, Daejon, Republic of Korea.

出版信息

Otol Neurotol. 2011 Dec;32(9):1486-91. doi: 10.1097/MAO.0b013e318235586c.

Abstract

OBJECTIVE

To determine whether cochlear hydrops analysis masking procedure (CHAMP) has diagnostic value in patients with definite Ménière's disease (MD) comparing the diagnostic validity index of CHAMP with those of electrocochleography (ECoG).

STUDY DESIGN

A prospective study.

SETTING

Tertiary referral center.

PATIENTS

One hundred eight patients were classified into 3 groups: the "definite MD" group (MD group, n = 47); the "non-MD" group (n = 41) of other vestibular diseases including vestibular neuritis, and benign paroxysmal positional vertigo; and the control group (n = 20), which included patients without dizziness.

INTERVENTIONS

CHAMP and extratympanic ECoG were performed in all patients.

MAIN OUTCOME MEASURE

Sensitivity, specificity, and definitions of abnormal values were less than 0.3 ms in latency delay (0.5 kHz high pass noise [HPN]-click alone) and less than 0.95 in compound amplitude ratio (click alone-0.5 kHz HPN/click alone) in CHAMP and 0.4 for the summating potential/action potential ratio in ECoG.

RESULTS

The mean latency delay and amplitude ratio of CHAMP in the MD group significantly differed from these values for other groups, whereas the mean summating potential/action potential ratio of ECoG did not. In ECoG, sensitivity was as low as 21%, specificity was 97%, and diagnostic accuracy was 62%. Sensitivity, specificity, and diagnostic accuracy of CHAMP were 64%, 98%, and 80%, respectively, in latency delay and 91%, 83%, and 88%, respectively, in amplitude ratio. The sensitivity and diagnostic accuracy of CHAMP were significantly higher than the corresponding values for ECoG.

CONCLUSION

CHAMP is more valuable in detection of definite MD than extratympanic ECoG.

摘要

目的

通过与鼓室电图(ECoG)比较,确定耳蜗积水分析掩蔽程序(CHAMP)在明确梅尼埃病(MD)患者中的诊断价值,分析 CHAMP 的诊断有效性指数。

研究设计

前瞻性研究。

设置

三级转诊中心。

患者

108 例患者被分为 3 组:“明确 MD”组(MD 组,n = 47);“非 MD”组(n = 41),包括前庭神经炎和良性阵发性位置性眩晕等其他前庭疾病;对照组(n = 20),包括无头晕的患者。

干预措施

所有患者均进行 CHAMP 和鼓室外 ECoG 检查。

主要观察指标

潜伏期延迟(0.5 kHz 高通噪声[HPN]-click 单独)小于 0.3 ms 和复合幅度比(click 单独-0.5 kHz HPN/click 单独)小于 0.95,CHAMP 中异常值的定义为潜伏期延迟和复合幅度比,而 ECoG 中的总和潜能/动作潜能比为 0.4。

结果

MD 组 CHAMP 的平均潜伏期延迟和幅度比与其他组明显不同,而 ECoG 的平均总和潜能/动作潜能比则不同。ECoG 的敏感性低至 21%,特异性为 97%,诊断准确率为 62%。CHAMP 的潜伏期延迟的敏感性、特异性和诊断准确率分别为 64%、98%和 80%,幅度比分别为 91%、83%和 88%。CHAMP 的敏感性和诊断准确性明显高于 ECoG 的相应值。

结论

CHAMP 比鼓室外 ECoG 更能检测明确的 MD。

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