OBJECTIVE: To evaluate the clinical effectiveness of performing electrocochleography (ECoG) at the initial visit in predicting hearing outcomes. STUDY DESIGN: Retrospective study. SETTING: Tertiary hospital. PATIENTS: Ninety patients with unilateral, definite Ménière's disease. INTERVENTIONS: The summating potential (SP)/action potential (AP) ratio was obtained using ECoG at the initial visits. An SP/AP ratio greater than 0.34 was considered abnormal. MAIN OUTCOME MEASURES: Audiogram types, hearing fluctuations, hearing thresholds at the initial and last visits, hearing changes, caloric response, and treatment outcomes were analyzed in subjects with normal and abnormal ECoGs. Correlation analyses between the SP/AP ratio at the initial visit, hearing thresholds at each visit, and hearing changes were performed. RESULTS: The mean follow-up period was 22.6 months. Abnormal ECoGs were found in 50 (55.6%) of the 90 subjects. No significant differences regarding audiogram types, hearing fluctuations, caloric response, or treatment outcomes were observed between subjects with normal and abnormal ECoGs. Ipsilateral SP/AP ratios at the initial visit were correlated with both hearing thresholds at the initial (r = 0.347, p < 0.001) and last (r = 0.435, p < 0.001) visits. Furthermore, there was a significant correlation between SP/AP ratio and hearing change during follow-up (r = 0.280, p = 0.008). After stratification by initial hearing level, Stage 1 and 2 subjects (hearing threshold, 0-40 dB) with abnormal ECoGs at the initial visit showed a decrease in hearing over time compared with those with normal ECoGs (p = 0.008). CONCLUSION: A high SP/AP ratio at the initial visit may be used as a predictor of poor hearing outcomes in subjects with Ménière's disease, especially with initial hearing Stage 1 and 2.
OBJECTIVE: To evaluate the clinical effectiveness of performing electrocochleography (ECoG) at the initial visit in predicting hearing outcomes. STUDY DESIGN: Retrospective study. SETTING: Tertiary hospital. PATIENTS: Ninety patients with unilateral, definite Ménière's disease. INTERVENTIONS: The summating potential (SP)/action potential (AP) ratio was obtained using ECoG at the initial visits. An SP/AP ratio greater than 0.34 was considered abnormal. MAIN OUTCOME MEASURES: Audiogram types, hearing fluctuations, hearing thresholds at the initial and last visits, hearing changes, caloric response, and treatment outcomes were analyzed in subjects with normal and abnormal ECoGs. Correlation analyses between the SP/AP ratio at the initial visit, hearing thresholds at each visit, and hearing changes were performed. RESULTS: The mean follow-up period was 22.6 months. Abnormal ECoGs were found in 50 (55.6%) of the 90 subjects. No significant differences regarding audiogram types, hearing fluctuations, caloric response, or treatment outcomes were observed between subjects with normal and abnormal ECoGs. Ipsilateral SP/AP ratios at the initial visit were correlated with both hearing thresholds at the initial (r = 0.347, p < 0.001) and last (r = 0.435, p < 0.001) visits. Furthermore, there was a significant correlation between SP/AP ratio and hearing change during follow-up (r = 0.280, p = 0.008). After stratification by initial hearing level, Stage 1 and 2 subjects (hearing threshold, 0-40 dB) with abnormal ECoGs at the initial visit showed a decrease in hearing over time compared with those with normal ECoGs (p = 0.008). CONCLUSION: A high SP/AP ratio at the initial visit may be used as a predictor of poor hearing outcomes in subjects with Ménière's disease, especially with initial hearing Stage 1 and 2.
Authors: Pauliana Lamounier; Débora Aparecida Gobbo; Thiago Silva Almeida de Souza; Carlos Augusto Costa Pires de Oliveira; Fayez Bahmad Journal: Braz J Otorhinolaryngol Date: 2014-08-27