Is Electrocochleography Still Helpful in Early Diagnosis of Meniere Disease?

Mammarella, Fulvio; Zelli, Melissa; Varakliotis, Theodoros; Eibenstein, Alberto; Pianura, Claudio Maria; Bellocchi, Gianluca

Abstract

BACKGROUND AND OBJECTIVES
Despite the extensive research for the Meniere's disease (MD), it's pathophysiology still remains uncertain and questionable among scientists. Clinical symptoms and audiometric tests form the basis for the diagnosis. Nevertheless the differential diagnosis can be extremely challenging, due to subjective and not specific results. Incorrect diagnosis is most likely and for this reason there is a great demand for objective and reliable tests.
SUBJECTS AND METHODS
The presence of endolymphatic hydrops is necessary condition but non enough for the diagnosis. In this study we analyze retrospectively the summating potentials (SP)/action protentials (AP) ratio from peritympanic electrocochleography in 34 patients,divided in two groups (13 patients classified as defined MD and 21 patients classified as probable MD). The purpose was to identify the utility of the exam so to be able to achieve an early defined diagnosis. Furthermore our intention was to obtain an objective test, besides the clinical criteria currently in use for the diagnosis and the classification of the MD.
RESULTS
The analysis of the SP/AP results shows high predictability for the MD (positive in six out of seven cases with a sensitivity greater than 80%).
CONCLUSIONS
Our study demonstrates a satisfactory sensibility percentage in recurrent defined MD presentation (>80%). Early identification of MD can lead to an early treatment and control of the progression of the disease. Furthermore it could be a valuable instrument for the follow up and evaluation of the patients classified as probable MD in accordance with the criteria of the American Academy of Otolaryngology-Head and Neck Surgery (1995).