Huang Muchen, Wang Xianren, Chen Minqi
Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China.
Front Neurosci. 2025 Jul 8;19:1600665. doi: 10.3389/fnins.2025.1600665. eCollection 2025.
This study aimed to evaluate the diagnostic and staging efficacy of integrating electrocochleography (ECochG) with vestibular function tests-specifically cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP), caloric test (CT), and video head impulse test (vHIT)-for Ménière's disease (MD).
Data were collected from 54 MD patients (66 affected ears) admitted to a hospital between January 2023 and January 2024. Each participant underwent pure tone audiometry, ECochG, cVEMP, oVEMP, CT, and vHIT. The results were compared against both established clinical criteria and a newly proposed staging system. Inclusion criteria followed the 2015 diagnostic guidelines for MD. Statistical analyses, including ANOVA, Chi-square, and Kruskal-Wallis H tests, were conducted, and a random forest model was employed to validate the robustness of the proposed staging system.
The novel staging system, incorporating vestibular function tests, demonstrated superior sensitivity and diagnostic accuracy compared to traditional audiometry-based staging. Early-stage MD detection improved significantly, with vestibular test abnormalities strongly correlating with disease progression. The overall positive rate for any test was 98.5%. ECochG abnormalities were detected in 54.5% of cases, while cVEMP and oVEMP abnormalities were observed in 75.8% and 69.7% of cases, respectively. The new staging system exhibited a stronger correlation with vestibular dysfunction, effectively identifying functional impairment prior to significant hearing loss.
The integration of ECochG with vestibular function tests provides a more comprehensive diagnostic framework for MD. This multimodal approach enhances early detection, improves staging accuracy, and offers deeper insights into disease progression, thereby facilitating more personalized treatment strategies.
本研究旨在评估将电耳蜗图（ECochG）与前庭功能测试——具体为颈性和眼性前庭诱发肌源性电位（cVEMP和oVEMP）、冷热试验（CT）以及视频头脉冲试验（vHIT）相结合，用于梅尼埃病（MD）诊断和分期的有效性。
收集了2023年1月至2024年1月期间收治于某医院的54例MD患者（66只患耳）的数据。每位参与者均接受了纯音听力测定、ECochG、cVEMP、oVEMP、CT和vHIT检查。将结果与既定的临床标准和新提出的分期系统进行比较。纳入标准遵循2015年MD诊断指南。进行了包括方差分析、卡方检验和Kruskal-Wallis H检验在内的统计分析，并采用随机森林模型来验证所提出分期系统的稳健性。
与传统的基于听力测定的分期相比，纳入前庭功能测试的新分期系统显示出更高的敏感性和诊断准确性。早期MD的检测有显著改善，前庭测试异常与疾病进展密切相关。任何一项测试的总体阳性率为98.5%。54.5%的病例检测到ECochG异常，而cVEMP和oVEMP异常分别在75.8%和69.7%的病例中观察到。新分期系统与前庭功能障碍的相关性更强，能在显著听力损失之前有效识别功能损害。
ECochG与前庭功能测试相结合为MD提供了更全面的诊断框架。这种多模式方法提高了早期检测率，改善了分期准确性，并为疾病进展提供了更深入的见解，从而有助于制定更个性化的治疗策略。
