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Vol. 63. Issue 6.
Pages 421-428 (November - December 2012)
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Vol. 63. Issue 6.
Pages 421-428 (November - December 2012)
Original article
DOI: 10.1016/j.otoeng.2012.11.003
Extratympanic Electrocochleography in Ménière's Disease
Electrococleografía extratimpánica en la enfermedad de Ménière
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Eduardo Martín-Sanz??
Corresponding author
emartinsanz@gmail.com

Corresponding author.
, Jonathan Esteban Sánchez, Manuel González Juliao, Christiane Zschaeck Luzardo, Teresa Mato Patino, Laura Rodrigañez Riesco, Ricardo Sanz Fernández
Servicio de Otorrinolaringología, Hospital Universitario de Getafe, Getafe, Madrid, Spain
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Tables (5)
Table 1. Stages of Definite Ménière's Disease (AAO–HNS, 1995). Mean Value of Thresholds for Pure Tone Audiogram at Frequencies of 500–1000–2000–3000Hz, the Worst Audiogram in the Previous 6 Months.
Table 2. Diagnostic Criteria for Ménière's Disease (AAO–HNS, 1995). Number of Patients in Each Stage According to Our Patient Population.
Table 3. Mean Gain and Time Constant Values of the Population in the Impulse Rotatory Test.
Table 4. Mean Gain, Phase and Symmetry Values of the Population in the Sinusoidal Rotatory Test.
Table 5. Percentage of Altered ECoG and Value of the Corresponding SP/AP Ratio Based on the Diagnosis According to the AAO–HNS Criteria.
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Abstract
Introduction

Electrocochleography is the registration of an electrophysiological event which takes place in the cochlea after an acoustical stimulus. Most of the authors consider an increased summating potential (SP)/action potential (AP) ratio as characteristic of endolymphatic hydrops.

Methods

A longitudinal, prospective study of a unilateral Ménière's population diagnosed according to the American Academy of Otolaryngology–Head and Neck Surgery classification was carried out. A complete clinical history and bedside examination were performed, in addition to complete auditory and vestibular testing and an extratympanic electrocochleography. We selected 20 normal hearing subjects with no history of vestibular and otological pathology as a control group.

Results

Of the 100 patients included in the study, 62 were diagnosed as definite Ménière's disease, and 13 and 25 as probable and possible Ménière's disease, respectively. In the electrocochleography, 85% of all the patients had an SP/AP ratio above 0.5. A sensibility of 92%, 78% and 75% was obtained in the definite, probable and possible Ménière's disease patients, respectively.

Discussion and conclusions

Electrocochleography is a useful method for diagnosing and evaluating patients with Ménière's disease syndrome. It provides information about the progression of the process and shows a significant correlation with the clinical stage.

Keywords:
Extratympanic electrocochleography
Ménière's disease
Vestibular testing
Resumen
Introducción

La electrococleografía (ECoG) es un registro de un episodio electrofisiológico, que tiene lugar en la cóclea tras un estímulo acústico. La mayoría de los autores consideran que un aumento del cociente SP/AP utilizando clicks, es característico del hidrops.

Métodos

Presentamos un estudio longitudinal y prospectivo de una población de pacientes con enfermedad de Ménière unilateral definida según los criterios de la Academia Americana de Otorrinolaringología y patología cervicofacial. Tras una correcta anamnesis y exploración otoneurológica completa, todos los pacientes fueron sometidos a un estudio de la función auditiva y vestibular mediante audiometría tonal liminar, pruebas calóricas, rotatorias y una ECoG extratimpánica. Como controles se escogieron 20 sujetos normoacúsicos carentes de antecedentes de afección vestibular u otológica, ni antecedentes quirúrgicos en el oído medio.

Resultados

De los 100 pacientes incluidos, 62 fueron diagnosticados de enfermedad de Ménière definida, 13 de probable y 25 de enfermedad de Ménière posible. Un 85% de la población con enfermedad de Ménière, cumplían criterios electrofisiológicos de enfermedad de Ménière según los parámetros de la ECoG (SP/AP>0,5). El porcentaje de ECoG alteradas según el diagnóstico era del 92, 78 y 75% para el Ménière definido, probable y posible respectivamente.

Discusión y conclusiones

La ECoG es un método útil para el diagnóstico y evaluación de la enfermedad de Ménière. Aporta información fidedigna del progreso de la enfermedad y existe correlación con su estadio diagnóstico.

Palabras clave:
Electrococleografía extratimpánica
Enfermedad de Ménière
Pruebas vestibulares

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