Kunelskaya N L, Manaenkova E A, Levina Yu V, Baybakova E V, Larionova E V
Sverzhevky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia.
Pirogov Russian National Research Medical University, Moscow, Russia.
Vestn Otorinolaringol. 2025;90(3):24-29. doi: 10.17116/otorino20259003124.
To calculate the sensitivity (Se) and specificity (Sp) indicators of clinical and instrumental diagnostic methods of labyrinth hydrops (LH) in patients with definite Meniere's disease (MD, according to the EAONO classification, 2015).
We examined 67 patients with definite MD: stage 1 - 24, stage 2 - 23, stage 3 - 20 patients, as well as 30 subjects with sensorineural hearing loss (control group) with tone hearing thresholds similar to those in patients with MD.
Clinical, otorhinolaryngological, otoneurological (using audiometric and vestibulometric tests) examinations, extratympanic electrocochleography, glycerol dehydration test. Statistical analysis of obtained results was performed with Statistica software package (version 10.0.1011).
It has been established that Se and Sp indicators of clinical and instrumental tests in patients with definite MD and confirmed LH depend on the disease stage according to neurovisualization data. Electrocochleography, audiometric curve type (ascending) and dehydration test are the most sensitive and specific for detection of LH at the first stage of MD (96%); electrocochleography, ultrasound audiometry, caloric and video impulse tests (their dissociation) - at the second stage of MD (96%); audiometric curve type (horizontal), caloric and video impulse tests and vHIT (their dissociation), registration of cervical vestibular evoked myogenic potentials (their asymmetry) - at the third stage of MD (95%).
The obtained results allow to optimize the diagnostic algorithm at suspicion on LH, as well as to reduce economic costs by eliminating test with low sensitivity and weak informativity.
计算确诊梅尼埃病(MD,根据2015年欧洲耳、鼻、喉科及头颈外科学会(EAONO)分类标准)患者迷路积水(LH)的临床及仪器诊断方法的敏感度(Se)和特异度(Sp)指标。
我们检查了67例确诊MD患者:1期24例,2期23例,3期20例,以及30例感音神经性听力损失受试者(对照组),其纯音听力阈值与MD患者相似。
进行临床、耳鼻喉科、耳神经科(使用听力测定和前庭功能测定试验)检查、鼓室外电耳蜗图检查、甘油脱水试验。使用Statistica软件包(版本10.0.1011)对所得结果进行统计分析。
已确定,根据神经可视化数据,确诊MD且证实存在LH的患者,临床及仪器检查的Se和Sp指标取决于疾病分期。电耳蜗图、听力曲线类型(上升型)和脱水试验对MD第一阶段LH的检测最敏感且特异(96%);电耳蜗图、超声听力测定、冷热试验和视频眼震电图(它们的分离)对MD第二阶段LH的检测最敏感且特异(96%);听力曲线类型(水平型)、冷热试验和视频眼震电图及视频头脉冲试验(它们的分离)、颈前庭诱发肌源性电位记录(它们的不对称性)对MD第三阶段LH的检测最敏感且特异(95%)。
所得结果有助于优化LH疑似病例的诊断算法,并通过剔除敏感度低和信息量少的检查来降低经济成本。