Electrocochleography in patients with Meniere's disease

Objective: The objective of this study was to evaluate the role of electrocochleography (ECoG) in the diagnosis of Meniere's disease. Study design: This study is a retrospective case review. Methods: Patients undergoing ECoG for Meniere's disease between 1995 and 2003 were identified and segregated as having definite, probable, or possible Meniere's disease according to the 1995 American Academy of Otolaryngology-Head and Neck Surgery guidelines for Meniere's disease classification. Those determined to have probable and possible Meniere's disease were then combined to form a less-than-definite group for statistical analysis. Electrocochleography summating potential (SP)/action potential (AP) ratios were determined, and ratios greater than 0.4 were considered abnormal. The 2 groups were then compared to assess for any correlation between ECoG with the 1995 American Academy of Otolaryngology-Head and Neck Surgery Meniere's disease classification. Results: Sixty patients with definite Meniere's disease and 37 with less-than-definite Meniere's disease were identified. Overall, 59.8% had abnormally elevated SP/AP ratios. Of those with definite Meniere's disease, 66.7% had abnormally elevated SP/AP ratios, whereas of those with less-than-definite Meniere's disease, 52.7% had abnormal ECoGs (P =.069). Conclusions: A significant difference in ECoG results was not seen between the definite and less-than-definite Meniere's disease groups. Furthermore, approximately 30% of those with definite Meniere's disease would not be classified as having Meniere's disease based on ECoG results. Because of its lack of sensitivity, ECoG should not play a decisive role in determining the presence or absence of Meniere's disease. (c) 2005 Elsevier Inc. All rights reserved.