Division of Otolaryngology-Head & Neck Surgery, University of Montreal, Montreal, Québec, Canada.
Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, Quebec, Canada.
Otolaryngol Head Neck Surg. 2024 Aug;171(2):494-501. doi: 10.1002/ohn.693. Epub 2024 Feb 28.
To evaluate the sensitivity and the specificity of summating potential (SP)/action potential (AP) area under the curve (AUC) ratio by a transtympanic electrode and a click stimulus (TT-CS), SP/AP AUC ratio by an extratympanic electrode and a click stimulus (ET-CS) and SP amplitude value by a transtympanic electrode and tone burst stimulus (TT-TBS) in regard of Ménière's disease (MD) diagnosis. This is the first study that compares SP amplitude value performed by a TT-TBS and the SP/AP AUC ratio performed by a TT-CS.
Retrospective comparative study.
Ninety-five patients met the inclusion criteria for electrocochleography (ECochG) testing in a tertiary care center.
The sensitivity and specificity of our different ECochG protocols were calculated in regard of the diagnosis of MD.
The patients' mean age was 54 years old (female predominance). The sensitivity and the specificity of SP/AP area ratio by a TT-CS were 88.5% and 70.0%, respectively. On the other hand, the sensitivity and specificity for the SP amplitude value by a TT-TBS were 60.0% and 55.6%, respectively. SP/AP area ratio by TT-CS was statistically better than SP amplitude value by TT-TBS to detect MD disease (P = .016). However, no difference was identified between SP/AP area ratio by ET-CS and SP amplitude value by a TT-TBS (P = .573).
SP/AP area ratio by click stimulation has higher sensitivity and specificity to detect MD compared to SP amplitude value by tone burst stimulation. ECochG would be extremely useful in the diagnosis of MD if we use the SP/AP area ratio (sensitivity: 88.5%); therefore, it changes the bad reputation of ECochG sensitivity using SP/AP amplitude ratio (sensitivity: 51.7%) for the diagnosis of MD.
评估经鼓电极和短声刺激（TT-CS）的总和电位（SP）/动作电位（AP）面积比、经鼓电极和 click 刺激（ET-CS）的 SP/AP 面积比以及经鼓电极和短纯音刺激（TT-TBS）的 SP 振幅值在梅尼埃病（MD）诊断中的灵敏度和特异性。这是第一项比较 TT-TBS 下的 SP 振幅值和 TT-CS 下的 SP/AP 面积比的研究。
回顾性比较研究。
在一家三级护理中心，有 95 名患者符合电 Cochleography（ECochG）测试的纳入标准。
计算了我们不同的 ECochG 方案在 MD 诊断中的灵敏度和特异性。
患者的平均年龄为 54 岁（女性为主）。TT-CS 的 SP/AP 面积比的灵敏度和特异性分别为 88.5%和 70.0%。另一方面，TT-TBS 的 SP 振幅值的灵敏度和特异性分别为 60.0%和 55.6%。TT-CS 的 SP/AP 面积比在检测 MD 疾病方面明显优于 TT-TBS 的 SP 振幅值（P=0.016）。然而，ET-CS 的 SP/AP 面积比和 TT-TBS 的 SP 振幅值之间没有差异（P=0.573）。
与短纯音刺激的 SP 振幅值相比，click 刺激的 SP/AP 面积比在检测 MD 方面具有更高的灵敏度和特异性。如果我们使用 SP/AP 面积比（灵敏度：88.5%），ECochG 将对 MD 的诊断非常有用；因此，它改变了使用 SP/AP 振幅比（灵敏度：51.7%）诊断 MD 的 ECochG 灵敏度的不良声誉。
