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Can electrocochleography in Meniere's disease be noninvasive?
Shakuntala Ghosh1, Ashok K Gupta, Sherbaaz Singh Mann
1Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Objectives:
To evaluate and compare the results of extratympanic and transtympanic electrocochleography (ECochg) in clinically diagnosed cases of Meniere's disease and controls.
Design:
Prospective study on 20 clinically diagnosed cases of Meniere's disease and 20 age- and sex-matched controls.
Setting:
Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Methods:
Electrocochleography was performed by a transtympanic method using a stainless steel needle electrode kept on the promontory and by an extratympanic method whereby the needle electrode was inserted into bony canal skin.
Main Outcome Measures:
The various parameters compared were summation potential latency and amplitude, action potential latency and amplitude, and ratio of summation to action potential amplitude (SP/AP).
Results:
A significant difference in summation to action potential amplitude ratio (SP/AP) between cases and controls was obtained by both methods. Using 0.29 as a cutoff for SP/AP, the transtympanic method yielded a sensitivity of 100% and a specificity of 90%, whereas the extratympanic method showed corresponding values of 90% and 80%, respectively.
Conclusion:
Contrary to previous studies, extratympanic ECochg is shown to be an efficacious and a less invasive test as compared with the transtympanic method and can be easily performed in clinical practice.