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Mean intracranial pressure monitoring by a non-invasive audiological technique: a pilot study
A Reid1, R J Marchbanks, D E Bateman
1Institute of Sound and Vibration Research, University of Southampton, Wessex, UK.
Insights
This study explored using tympanic membrane displacement to non-invasively monitor intracranial pressure in patients. The technique shows promise for serial intracranial pressure monitoring in young hydrocephalus and benign intracranial hypertension patients.
Area of Science:
- Neuroscience
- Otolaryngology
- Medical Engineering
Background:
- Intracranial pressure (ICP) is normally transmitted to the cochlear perilymph via the cochlear aqueduct.
- Accurate ICP monitoring is crucial for managing various neurological conditions.
- Non-invasive methods for ICP assessment are highly desirable.
Purpose of the Study:
- To examine the relationship between perilymphatic pressure and mean intracranial pressure.
- To evaluate tympanic membrane displacement as an indirect measure of intracranial pressure.
- To assess the utility of this technique in patients with elevated ICP.
Main Methods:
- Indirect measurement of perilymphatic pressure via tympanic membrane displacement.
- Comparison with clinically or directly measured mean intracranial pressure.
- Study included 58 patients (aged 5-77 years) with conditions like hydrocephalus, benign intracranial hypertension, tumors, subarachnoid hemorrhage, and head injuries.
Main Results:
- Consistent correlations between tympanic membrane displacement and ICP were observed in young patients with hydrocephalus and benign intracranial hypertension.
- The technique was unsuitable when the stapedial reflex was absent (middle ear/brainstem dysfunction).
- The method failed to reflect ICP when the cochlear aqueduct was not patent.
Conclusions:
- Tympanic membrane displacement is a potentially useful non-invasive method for serial intracranial pressure monitoring.
- This technique appears most suitable for young patients diagnosed with hydrocephalus or benign intracranial hypertension.
- Further validation is needed, considering limitations related to middle ear function and cochlear aqueduct patency.
Abstract:
Intracranial pressure is normally transmitted to the perilymph of the cochlea via the cochlear aqueduct. The relationship between perilymphatic pressure, indirectly measured by tympanic membrane displacement, and mean intracranial pressure defined either clinically or by direct measurement has been examined in 58 patients (aged 5-77 years), with hydrocephalus, benign intracranial hypertension, intracranial tumours, subarachnoid haemorrhage and head injuries. The most consistent results were obtained in young patients with hydrocephalus and benign intracranial hypertension. However, the technique was not suitable when the stapedial reflex was absent as a result of middle ear/brainstem dysfunction and did not reflect intracranial pressure when the cochlear aqueduct was not patent. This pilot study suggests that the tympanic membrane displacement technique may provide a useful non-invasive method for serial monitoring of intracranial pressure in young patients with hydrocephalus or benign intracranial hypertension.