Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2007
Lack of diagnostic value of high-pass noise masking of auditory brainstem responses in Ménière's disease.
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De Valck Claudia F J, Claes Gerd M E, Wuyts Floris L, Van de Heyning Paul H
Аннотация
INTRODUCTION: Different electrophysiologic tests were developed to ascertain or detect endolymphatic hydrops (ELH). Recently, Cochlear Hydrops Analysis Masking Procedure (CHAMP), a new auditory brainstem response (ABR) technique, proved to be able to separate normal controls from definite Ménière's disease (MD) with 100% sensitivity and 100% specificity.
OBJECTIVE: To evaluate the applicability and diagnostic value of CHAMP in a series of MD and non-MD patients with otovestibular complaints.
STUDY DESIGN: An observational retrospective study.
SETTING: Tertiary referral centre.
PATIENTS: Forty-five patients, of which 28 patients had MD.
INTERVENTIONS: Cochlear Hydrops Analysis Masking Procedure test was conducted, and audiometric data and clinical information were collected. All responses were blindly evaluated and divided into three categories: (1) test suggestive for cochlear/ELH, (2) test within normal ranges, and (3) test not interpretable.
MAIN OUTCOME MEASURES: Sensitivity and specificity, evaluation of diagnostic value.
RESULTS: Forty-nine percent of the tests were found to be not interpretable. Of the remaining responses, 13 tests were suggestive for ELH, and 16 tests were within normal ranges. This yields a sensitivity of 31% and a specificity of 28%. There was no significant difference between the mean latency difference (mean [SD]) for Wave V of the MD group (0.43 ms [0.37]) and the non-MD group (0.65 ms [0.44]). Using logistic regression analysis, we found that CHAMP test did not contribute to the ability to discriminate between hydropic and nonhydropic ears.
CONCLUSION: In contrast to studies assessing CHAMP performance in Ménière patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Ménière's from non-MD subjects with otovestibular symptoms.
OBJECTIVE: To evaluate the applicability and diagnostic value of CHAMP in a series of MD and non-MD patients with otovestibular complaints.
STUDY DESIGN: An observational retrospective study.
SETTING: Tertiary referral centre.
PATIENTS: Forty-five patients, of which 28 patients had MD.
INTERVENTIONS: Cochlear Hydrops Analysis Masking Procedure test was conducted, and audiometric data and clinical information were collected. All responses were blindly evaluated and divided into three categories: (1) test suggestive for cochlear/ELH, (2) test within normal ranges, and (3) test not interpretable.
MAIN OUTCOME MEASURES: Sensitivity and specificity, evaluation of diagnostic value.
RESULTS: Forty-nine percent of the tests were found to be not interpretable. Of the remaining responses, 13 tests were suggestive for ELH, and 16 tests were within normal ranges. This yields a sensitivity of 31% and a specificity of 28%. There was no significant difference between the mean latency difference (mean [SD]) for Wave V of the MD group (0.43 ms [0.37]) and the non-MD group (0.65 ms [0.44]). Using logistic regression analysis, we found that CHAMP test did not contribute to the ability to discriminate between hydropic and nonhydropic ears.
CONCLUSION: In contrast to studies assessing CHAMP performance in Ménière patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Ménière's from non-MD subjects with otovestibular symptoms.