Summating-potential/action-potential ratio in normal ears: effects of dehydration

Studies using electrocochleography (ECoG) in patients with Meniere's disease and in patients with perilymph fistula have demonstrated abnormally large summating-potential (SP) components compared with the amplitude of the action-potential (AP). The possible influence of normal physiological variation, methodological differences, and test-retest variations are often difficult to interpret. The purpose of this study is to specify what constitutes a clinically important change in the SP/AP ratio in normal hearing subjects under the condition of dehydration induced by urea.

Baseline ECoG was performed on 20 normal hearing volunteer subjects after an 8 hour fast. Urea, 20 g, was administered orally, following which recordings were made at 60 and 90 minutes. The majority of subjects were found to have maximal SP/AP changes at 60 minutes post dehydration; therefore, only these results were included in the final analysis. Subsets of data were statistically evaluated.

In all ears but one, the preingestion SP/AP ratio was less than or equal to 0.37. Male and female data were shown to comprise separate populations both before and following dehydration. The 95% upper limit for baseline SP/AP ratio was 0.39 for males and was 0.25 for females. The gender-related difference remained after dehydration. The mean male SP/AP ratio showed a statistically significant but slight decrease whereas the female SP/AP ratio was unaltered.

These data demonstrate a statistically significant gender-related difference in SP/AP ratio in normals. The upper limit of normal is 0.39 for males and 0.25 for females. A basis for the gender difference is puzzling and requires further investigation. Dehydration produces a statistically significant reduction in SP/AP ratio in men. This change was not observed in women.