Application Of Electrocochleography And Vestibular-evoked Myogenic Potentials In Different Stages Of Meniere’s Disease

Objective:Meniere’s disease is a progressive,idiopathic inner ear disease resulting in hearing of loss.Currently,diagnosis for Meniere’s disease largely rely on the hearing function tests,due to the lack of direct pathological basis and atypical symptoms.Many studies showed that the Electrocochleography is the most valuable electrophysiological examination on the diagnosis for Meniere ’ disease.Endolymphatic hydrops is a histopathological finding of the disease and occurs more often in the cochlea and saccule,followed by the utricle and semicircular canals.The VEMPs examination results can objectively reflect the functional status of vestibular nerves and otolith apparatus.The ocular Vestibular-evoked myogenic potentials(oVEMP)and cervical Vestibular-evoked myogenic potentials(cVEMP).The purpose of this study was to discusses and compares the sensitivity and clinical significance of two tests in the diagnosis of different hearing stages of MD by studying the VEMPs and electrocochleogram parameters in Meniere’s disease patients.Method: According to the diagnosis and treatment of 2017 Meniere disease in China,80 cases(80 ears)of unilateral Meniere’s disease patients who were Vertigo Center and inpatient in Tianjin Medical University General Hospital between June2017 and 2018 May were received electrocochleography and VEMP examination during different stages.marking the parameters of the examination.27 healthy volunteers(54 ears)with normal hearing were selected as the normal control group.Establish the normal range of laboratories for VEMPs and electrograms.The SP and AP amplitudes,SP/AP amplitude ratios,SP/AP area parameters,N1-P1 amplitude,N1 latency,P1 latency,asymmetry rate were recorded and compared between the Meniere group and the control group.To compare the abnormal detection rate of electroencephalogram and VEMPs during different hearing loss periods in Meniere’s disease group,to compare the parameters of oVEMP during different hearing loss,and to compare the amplitude ratio and area ratio of electroencephalogram and the amplitude of VEMPN1-P1,the latency of N1 and P1.Result: The abnormal rates of electrocochleography in Meniere ’s disease stage1,2,3,4 were 50.00%、66.67%、84.62%、94.44% respectively,The abnormal ratesof oVEMP in Meniere ’s disease stage1,2,3,4 were 33.33%、50.00%、78..08%、83.33%respectively,and the abnormal rates of cVEMP were 25.00%、50.00%、38.46%、44.44%.The overall abnormal rate of the three examinations generally showed an upward trend with the decline of the Meniere’s hearing stage.In oVEMPs and cVEMPs,the amplitude of N1-P1 was significantly reduced in Meniere’s patients compared to the control group,and the latent period of N1 and P1 of oVEMP was significantly prolonged,and the cVEMP did not change significantly.the amplitude of oVEMP were5.098±5.179μV,4.168±2.181μV,4.443±2.865 μV,3.918±2.099μV,respectively.The asymmetry rate was 0.251±0.120 0.171±0.151 0.181±0.1690.201 ± 0.117.The amplitude ratio of SP/AP on the affected side of the electrocochleography was 0.522 ± 0.119,and the ratio of SP/AP area was 1.966 ±0.391,which increased with the stage of Meniere’s disease.The increase is significant.Conclusion: 1.The amplitudes of oVEMP and cVEMP P1-N1 in patients with Meniere’s ear were reduced,and the latency of oVEMP P1 and N1 prolonged latency was more common than cVEMP.2.The amplitudes of oVEMP and cVEMP parameters will gradually decrease with the increase in the hearing stage of Meniere’s patients.This may be due to the severity of the lesions of the balloon and utricle in Meniere’s patients.The amplitudes of cVEMP and oVEMP in the affected ear decreased with the increase of Meniere ’s disease staging,showing that the damage of saccule and utricle function was positively correlated with disease severity.3.The SP amplitude,SP/AP amplitude ratio,and area of the electrocochlear electrogram of Meniere’s group were higher than those of the control group,showing that the damage of endolymphatic hydrops was positively correlated with disease severity.4.Two examinations examined the principle of Meniere’s treatment to patients,but the detection rate of Meniere’s patients was not low.In this experiment,the detection rate of the electrocochleogram of Meniere was higher than that of VEMPs.