Utility of area curve ratio electrocochleography in early Meniere disease
Utility of area curve ratio electrocochleography in early Meniere disease
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DOI：
10.1001/archotol.129.5.547
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发表时间：
2003-05-01
影响因子：
--
通讯作者：
Ator, GA
中科院分区：
文献类型：
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作者：
Devaiah, AK;Dawson, KL;Ator, GA
背景：耳蜗电图（ECochG）有助于梅尼埃病（MD）的诊断。可能的MD（早期疾病，由1995年美国耳鼻咽喉头颈外科学会听力和平衡委员会定义）是一种容易治疗的MD。目的：确定ECochG总和电位/动作电位（SP/AP）面积曲线测量在检测可能的MD中是否比常规SP/AP振幅比更敏感。进行了3年（1997-2000）的回顾性病历审查。检查所有诊断为患有MD并接受过鼓室ECochG的患者的图表，以识别可能患有MD的患者。排除标准为不完整的检查，使用先前系统进行的ECochG，耳蜗微音尖峰模糊率测量和先前的耳科手术。确定了SP/AP比值和ECochG数据正常的对照组患者。结果：138例MD患者中，20例（14%）可能有MD，8例通过排除标准。听力学家对患者的诊断不知情，进行所有测量。对照组耳（n=13）的SP/AP振幅和面积曲线比值的正常上限（α = 0.05）与先前发表的结果相似。8例可能MD患者中，4例SP/AP振幅比异常，7例SP/AP面积曲线比异常;组间差异有统计学意义（P= 0.03，χ 2）。结论：SP/AP面积曲线比显著提高ECochG诊断可能MD的敏感性。这种ECochG改进将允许早期干预以保留MD的内耳功能。
Background: Electrocochleography (ECochG) is useful in supporting the diagnosis of Meniere disease (MD). Possible MD (early disease as defined by the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium) is a readily treatable form of MD.Objectives: To identify whether ECochG summating potential/action potential (SP/AP) area curve measures are more sensitive than conventional SP/AP amplitude ratios in detecting possible MD.Patients and Methods: A retrospective chart review of a 3-year period (1997-2000) was conducted. All charts of patients diagnosed as having MD who had undergone tympanic ECochG were examined to identify those with possible MD. Exclusion criteria were incomplete workup, ECochG performed using a prior system, cochlear microphonic spike obscuring ratio measurements, and prior otologic surgery. A control group of patients with normal SP/AP ratios and ECochG data were identified. SP/AP amplitude and area curve ratios for both groups were measured.Results: Of 138 patients with MD reviewed, 20 (14%) had possible MD, and 8 passed exclusion criteria. An audiologist blinded to patients' diagnoses performed all measurements. The upper limit of normal for SP/AP amplitude and area curve ratios from the control group of ears (n=13) (alpha=.05) were similar to previously published results. Of the 8 patients with possible MD, 4 had an abnormal SP/AP amplitude ratio, and 7 had an abnormal SP/AP area curve ratio; the difference between groups was statistically significant (P=.03, chi(2)).Conclusions: The SP/AP area curve ratio significantly improves ECochG diagnostic sensitivity in possible MD. This ECochG refinement will allow earlier intervention to preserve inner ear function in MD.