Lack of diagnostic value of high-pass noise masking of auditory brainstem responses in Meniere's disease
Faculty of Sciences. Physics
Faculty of Medicine and Health Sciences
Otology and neurotology. - Philadelphia, Pa.
, p. 700-707
University of Antwerp
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 Meniere'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 Meniere patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Meniere's from non-MD subjects with otovestibular symptoms.