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MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Ménière's Disease.

Hornibrook J, Flook E, Greig S, Babbage M, Goh T, Coates M, Care R, Bird P - Otol. Neurotol. (2015)

Bottom Line: Diagnostic.A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%).Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.

View Article: PubMed Central - PubMed

Affiliation: Departments of *Otolaryngology-Head and Neck Surgery and †Radiology, Christchurch Hospital, Christchurch; ‡Department of Communication Disorders, University of Canterbury, Christchurch; and §University of Otago, Christchurch, New Zealand.

ABSTRACT

Objective: To compare the sensitivity of gadolinium MRI inner imaging with tone burst electrocochleography (EcochG) for diagnosing endolymphatic hydrops.

Study design: A prospective study on patients who were to have an MRI scan to exclude retrocochlear pathology.

Setting: Tertiary care center.

Patients: One hundred and two patients: 57 patients with Possible, Probable, or Definite Ménière's Disease, 25 with asymmetrical hearing loss, 18 with sudden sensorineural hearing loss, and 2 with unilateral tinnitus had additional MRI inner ear imaging and click and tone burst stimulus EcochG testing.

Intervention: Diagnostic.

Main outcome measure: To compare the sensitivity of the two techniques.

Results: In 30 patients with symptom-based Definite Ménière's Disease, tone burst EcochG was positive in 25 (83%) and the click EcochG was positive in 9/30 (30%), and gadolinium MRI imaging diagnosed hydrops in 14 (47%). A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%). In 14 subjects with symptom-based Probable Ménière's Disease, 10 (71%) had either a positive EcochG or MRI. In 13 with Possible Ménière's Disease, four (31%) had a positive EcochG or MRI.

Conclusion: This study confirms the greatly enhanced diagnostic sensitivity of tone burst EcochG over click response in diagnosing endolymphatic hydrops in Ménière's disease. Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.

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Related in: MedlinePlus

Magnetic resonance imaging of the left inner ear of a Ménière’s patient. The perilymph sequence demonstrates enlargement of the endolymphatic compartment in the cochlea and endolymph filling the vestibule. P = perilymph, E = endolymph.
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Figure 3: Magnetic resonance imaging of the left inner ear of a Ménière’s patient. The perilymph sequence demonstrates enlargement of the endolymphatic compartment in the cochlea and endolymph filling the vestibule. P = perilymph, E = endolymph.

Mentions: In the group of 30 clinically Definite Ménière’s patients, gadolinium MRI was positive in 14 (47%). If the two patients with a profound hearing loss in the test ear were excluded (EcochG unobtainable), then a positive yield for EcochG testing was 89%. A positive result for either EcochG or MRI was seen in 26 patients (87%). Excluding profound hearing loss patients gives positive results in 26 of 28 patients (i.e., 93%). See Table 4 for further breakdown of results. Figure 2 shows a normal (non-hydropic) ear. Figure 3 shows endolymphatic hydrops in Ménière’s ear.


MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Ménière's Disease.

Hornibrook J, Flook E, Greig S, Babbage M, Goh T, Coates M, Care R, Bird P - Otol. Neurotol. (2015)

Magnetic resonance imaging of the left inner ear of a Ménière’s patient. The perilymph sequence demonstrates enlargement of the endolymphatic compartment in the cochlea and endolymph filling the vestibule. P = perilymph, E = endolymph.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4478066&req=5

Figure 3: Magnetic resonance imaging of the left inner ear of a Ménière’s patient. The perilymph sequence demonstrates enlargement of the endolymphatic compartment in the cochlea and endolymph filling the vestibule. P = perilymph, E = endolymph.
Mentions: In the group of 30 clinically Definite Ménière’s patients, gadolinium MRI was positive in 14 (47%). If the two patients with a profound hearing loss in the test ear were excluded (EcochG unobtainable), then a positive yield for EcochG testing was 89%. A positive result for either EcochG or MRI was seen in 26 patients (87%). Excluding profound hearing loss patients gives positive results in 26 of 28 patients (i.e., 93%). See Table 4 for further breakdown of results. Figure 2 shows a normal (non-hydropic) ear. Figure 3 shows endolymphatic hydrops in Ménière’s ear.

Bottom Line: Diagnostic.A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%).Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.

View Article: PubMed Central - PubMed

Affiliation: Departments of *Otolaryngology-Head and Neck Surgery and †Radiology, Christchurch Hospital, Christchurch; ‡Department of Communication Disorders, University of Canterbury, Christchurch; and §University of Otago, Christchurch, New Zealand.

ABSTRACT

Objective: To compare the sensitivity of gadolinium MRI inner imaging with tone burst electrocochleography (EcochG) for diagnosing endolymphatic hydrops.

Study design: A prospective study on patients who were to have an MRI scan to exclude retrocochlear pathology.

Setting: Tertiary care center.

Patients: One hundred and two patients: 57 patients with Possible, Probable, or Definite Ménière's Disease, 25 with asymmetrical hearing loss, 18 with sudden sensorineural hearing loss, and 2 with unilateral tinnitus had additional MRI inner ear imaging and click and tone burst stimulus EcochG testing.

Intervention: Diagnostic.

Main outcome measure: To compare the sensitivity of the two techniques.

Results: In 30 patients with symptom-based Definite Ménière's Disease, tone burst EcochG was positive in 25 (83%) and the click EcochG was positive in 9/30 (30%), and gadolinium MRI imaging diagnosed hydrops in 14 (47%). A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%). In 14 subjects with symptom-based Probable Ménière's Disease, 10 (71%) had either a positive EcochG or MRI. In 13 with Possible Ménière's Disease, four (31%) had a positive EcochG or MRI.

Conclusion: This study confirms the greatly enhanced diagnostic sensitivity of tone burst EcochG over click response in diagnosing endolymphatic hydrops in Ménière's disease. Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.

Show MeSH
Related in: MedlinePlus