Abstract
Electrocochleography (ECoG) has been an important tool in the diagnosis of Meniere’s disease or endolymphatic hydrops. There are two methods employed, transtympanic and extratympanic. Many have regarded the results of these methods as being equally reliable. The purpose of this study is to determine any differences in sensitivity between the two methods. In this study patients with known endolymphatic hydrops or Meniere’s disease underwent ECoG testing with both the extratympanic method and the transtympanic method on the same day in the same ear. The results show a significant difference between the two methods, with the transtympanic wave values being smaller and therefore more sensitive than the extratympanic method. In addition, transtympanic ECoG resulted in better waveform morphology and better correlation with the audiometric findings in endolymphatic hydrops and Meniere’s disease. The results emphasize the superior role of transtympanic ECoG over extratympanic ECoG as a valuable component in the confirmation of Meniere’s disease or endolymphatic hydrops along with history and audiometric findings characteristic of the disease. Implications of the study promote the use of transtympanic ECoG rather than extratympanic ECoG in patients with symptoms suggestive of Meniere’s disease or endolymphatic hydrops.
Highlights
Electrocochleography (ECoG) has been an important tool in the diagnosis and monitoring of Meniere’s disease/ endolymphatic hydrops and includes the components of the summating potential (SP) and action potential (AP) generated by the cochlea and auditory nerve respectively
The results show a significant difference between the two methods, with the transtympanic wave values being smaller and more sensitive than the extratympanic method
SP/AP ratios were obtained from ECoG testing
Summary
Electrocochleography (ECoG) has been an important tool in the diagnosis and monitoring of Meniere’s disease/ endolymphatic hydrops and includes the components of the summating potential (SP) and action potential (AP) generated by the cochlea and auditory nerve respectively. The recording needle electrode may be placed on the cochlear promontory transtympanically (TT) or placed within the medial external auditory canal/TM extratympanically (ET). The nearer in proximity to the recording electrode is placed in the cochlea, the more robust the evoked potentials will be. There are two techniques for obtaining the waveforms: transtympanic (TT) and extratympanic (ET). Krueger and Wagner demonstrated that the same waveforms may be obtained by placing the needle at the promontory, lateral, or medial niches [3]
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More From: International Journal of Otolaryngology and Head & Neck Surgery
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