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메니에르병에서 Cochlear Hydrops Analysis Masking Procedure 검사의 진단적 의의

Diagnostic Value of Cochlear Hydrops Analysis Masking Procedure in Meniere’s Disease

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참고문헌

주제분류이비인후과학

초록

Background and Objectives The diagnosis of Meniere’s disease is based on audiological test and clinical symptoms. Cochlear Hydrops Analysis Masking Procedure (CHAMP) was introduced as a test for detecting changes in physical characteristics of basilar membrane by hydrops of endolympahtic system. The aim of this study is to evaluate the diagnostic value and usefulness of CHAMP tests for detection of endolymphatic hydrops. Subjects and Method This study was performed on 11 cases of Meniere’s disease and 10 cases of vestibular neuritis who visited ENT outpatient clinic and 25 cases of normal healthy volunteers. We defined the positive value as being less than 0.3 ms in latency delay (0.5 kHz HPN-click alone) and less than 0.95 nV in compound amplitude ratio (click alone 0.5 kHz HPN/ click alone) regardless of age or sex. Results There were significant latency delays in the Meniere’s disease group compared with the vestibular neuritis and normal control group. The amplitude ratio gave significant differences between the Meniere’s disease group and the normal group but there were no differences between the Meniere’s disease group and the vestibular neuritis group. Without assuming the test failure, the sensitivity and specificity of latency delay was 81% and 100%, respectively, and the sensitivity and specificity of amplitude ratio was 100% and 84%, respectively. In 8 of 54 cases (14.8%), we couldn’t get interpretable wave. Conclusion CHAMP test is a clinically useful method that can detect endolymphatic hydrops and it can be used as an objective test for the diagonosis of Meniere’s disease.

Abstract

Background and Objectives The diagnosis of Meniere’s disease is based on audiological test and clinical symptoms. Cochlear Hydrops Analysis Masking Procedure (CHAMP) was introduced as a test for detecting changes in physical characteristics of basilar membrane by hydrops of endolympahtic system. The aim of this study is to evaluate the diagnostic value and usefulness of CHAMP tests for detection of endolymphatic hydrops. Subjects and Method This study was performed on 11 cases of Meniere’s disease and 10 cases of vestibular neuritis who visited ENT outpatient clinic and 25 cases of normal healthy volunteers. We defined the positive value as being less than 0.3 ms in latency delay (0.5 kHz HPN-click alone) and less than 0.95 nV in compound amplitude ratio (click alone 0.5 kHz HPN/ click alone) regardless of age or sex. Results There were significant latency delays in the Meniere’s disease group compared with the vestibular neuritis and normal control group. The amplitude ratio gave significant differences between the Meniere’s disease group and the normal group but there were no differences between the Meniere’s disease group and the vestibular neuritis group. Without assuming the test failure, the sensitivity and specificity of latency delay was 81% and 100%, respectively, and the sensitivity and specificity of amplitude ratio was 100% and 84%, respectively. In 8 of 54 cases (14.8%), we couldn’t get interpretable wave. Conclusion CHAMP test is a clinically useful method that can detect endolymphatic hydrops and it can be used as an objective test for the diagonosis of Meniere’s disease.

참고문헌 (9)

  1. "Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniére’s disease", Otolaryngol Head Neck Surg, 113(3), pp.181~185 (1995), American Academy of Otolaryngology-Head and Neck Foundation
  2. Colon BJ, "Electrocochleography in the diagnosis of Meniere’s disease", Acta Otolaryngol, 120(4), pp.480~483 (2000)
  3. Magliulo G, "Distortion-product otoacoustic emissions and glycerol testing in endolymphatic hydrops", Laryngoscope, 111(1), pp.102~109 (2001)
  4. Murofushi T, "Glycerol affects vestibular evoked myogenic potentials in Meniere’s disease", Auris Nasus Larynx, 28(3), pp.205~208 (2001)
  5. Magliulo G, "Vestibular evoked myogenic potentials and distortion-product otoacoustic emissions combined with glycerol testing in endolymphatic hydrops: their value in early diagnosis", Ann Otol Rhinol Laryngol, 113(12), pp.1000~1005 (2004)
  6. Don M, "A diagnostic test for Ménière’s disease and cochlear hydrops; impaired high pass noise masking of auditory brainstem responses", Otol Neurotol, 26(4), pp.711~722 (2005)
  7. Don M, "An alternative diagnostic test for active Ménière’s disease and cochlear hydrops using high-pass noise masked responses: the complex amplitude ratio", Audiol Neurootol, 12(6), pp.359~370 (2007)
  8. Kim JS, "Principles of the stacked ABR", Audiology, 1(1), pp.1~7 (2005)
  9. De Valck CF, "Lack of diagnostic value of high-pass noise masking of auditory brainstem responses in Ménière’s disease", Otol Neurotol, 28(5), pp.700~707 (2007)

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