Lack of Diagnostic Value of High-Pass Noise Masking of Auditory Brainstem Responses in Ménière's Disease

Abstract

Different electrophysiologic tests were developed to ascertain or detect endolymphatic hydrops (ELH). Recently, Cochlear Hydrops Analysis Masking Procedure (CHAMP), a new auditory brainstem response (ABR) technique, proved to be able to separate normal controls from definite Ménière's disease (MD) with 100% sensitivity and 100% specificity. To evaluate the applicability and diagnostic value of CHAMP in a series of MD and non-MD patients with otovestibular complaints. An observational retrospective study. Tertiary referral centre. Forty-five patients, of which 28 patients had MD. Cochlear Hydrops Analysis Masking Procedure test was conducted, and audiometric data and clinical information were collected. All responses were blindly evaluated and divided into three categories: (1) test suggestive for cochlear/ELH, (2) test within normal ranges, and (3) test not interpretable. Sensitivity and specificity, evaluation of diagnostic value. Forty-nine percent of the tests were found to be not interpretable. Of the remaining responses, 13 tests were suggestive for ELH, and 16 tests were within normal ranges. This yields a sensitivity of 31% and a specificity of 28%. There was no significant difference between the mean latency difference (mean [SD]) for Wave V of the MD group (0.43 ms [0.37]) and the non-MD group (0.65 ms [0.44]). Using logistic regression analysis, we found that CHAMP test did not contribute to the ability to discriminate between hydropic and nonhydropic ears. In contrast to studies assessing CHAMP performance in Ménière patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Ménière's from non-MD subjects with otovestibular symptoms.