B J Conlon1, W P Gibson. 1. Department of Surgery/Otolaryngology, The University of Sydney, Australia.
Abstract
OBJECTIVE: This study analyzes the incidence of endolymphatic hydrops in the asymptomatic contralateral ear of patients with classic Meniere's disease. STUDY DESIGN: A retrospective study of 3000 subjects who underwent electrocochleography (ECOG) from 1988 to 1998. METHODS: The presence of endolymphatic hydrops was determined by use of ECOG recordings, which were made through a transtympanic recording needle situated in the round window niche. Analysis was made of the 1-kHz toneburst summation potential (SP), and comparison was made between asymptomatic contralateral "Meniere's ears" (n = 144) and asymptomatic normal "control ears" (n = 114). RESULTS: Results demonstrated that more than 10% of the contralateral asymptomatic Meniere's ears have an ECOG recording that is highly suggestive of the presence of endolymphatic hydrops. In contrast, less than 2% of the control population demonstrate abnormal ECOG recordings. Furthermore, 15% of the population of contralateral Meniere's ears lie above the 95th percentile of the control population for 1-kHz tone-burst (100 dB) SP negativity. CONCLUSIONS: This study suggests that a high percentage of patients who have what appears to be unilateral Meniere's disease have evidence of endolymphatic hydrops in the contralateral asymptomatic ear. This finding has important clinical relevance for the management of patients in whom destructive surgery is planned and further highlights the importance of electrocochleography in the diagnosis and management of this disease process.
OBJECTIVE: This study analyzes the incidence of endolymphatic hydrops in the asymptomatic contralateral ear of patients with classic Meniere's disease. STUDY DESIGN: A retrospective study of 3000 subjects who underwent electrocochleography (ECOG) from 1988 to 1998. METHODS: The presence of endolymphatic hydrops was determined by use of ECOG recordings, which were made through a transtympanic recording needle situated in the round window niche. Analysis was made of the 1-kHz toneburst summation potential (SP), and comparison was made between asymptomatic contralateral "Meniere's ears" (n = 144) and asymptomatic normal "control ears" (n = 114). RESULTS: Results demonstrated that more than 10% of the contralateral asymptomatic Meniere's ears have an ECOG recording that is highly suggestive of the presence of endolymphatic hydrops. In contrast, less than 2% of the control population demonstrate abnormal ECOG recordings. Furthermore, 15% of the population of contralateral Meniere's ears lie above the 95th percentile of the control population for 1-kHz tone-burst (100 dB) SP negativity. CONCLUSIONS: This study suggests that a high percentage of patients who have what appears to be unilateral Meniere's disease have evidence of endolymphatic hydrops in the contralateral asymptomatic ear. This finding has important clinical relevance for the management of patients in whom destructive surgery is planned and further highlights the importance of electrocochleography in the diagnosis and management of this disease process.