Enhancing the sensitivity of electrocochleography in the diagnosis of meniere’s disease

Abstract

Background: Electrocochleography (ECochG), a technique for recording the stimulus-related potentials of the inner ear and auditory nerve, is widely used in the diagnosis of Meniere’s disease (MD). Unfortunately, the sensitivity of ECochG in the general Meniere’s population is only around 60%. Our laboratory has developed new protocols for recording and interpreting the electrocochleogram that are designed to improve this value.

Purpose: This study compared several features of the human electrocochleogram that are used in the diagnosis of MD to determine which feature (or combination of features) is the most sensitive to this particular disorder.

Methodology: ECochG results from 208 patients suspected of having MD were compared to the eventual diagnosis, as determined by their referring physicians. ECochG features analyzed for this purpose included the click-evoked amplitudes of the cochlear summating potential (SP) and auditory nerve action potential (AP), AP-N1 latency, and the SP/AP amplitude and area ratios. SP amplitude to toneburst (TB) stimuli also was measured.

Results and conclusion: Measurement of the SP/AP amplitude ratio leads to a sensitivity of 66%, slightly better than what has been reported in the literature. Measurement of the SP/AP area ratio, however, improves the sensitivity of ECochG to 92%. None of the other features, either individually or in combination, were statistically significant on the overall sensitivity of ECochG. Thus, the SP/AP area ratio is the most sensitive feature of ECochG in the diagnosis of MD. In addition, the recording time of ECochG can be shortened by eliminating measurement of the SP to TB stimuli.