Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-26T17:36:37.590Z Has data issue: false hasContentIssue false
  • English
  • Français

Verification of a new test of endolymphatic hydrops

Published online by Cambridge University Press:  29 June 2007

A. R. D. Thornton ,
G. Farrell ,
A. J. Phillips ,
N. P. Haacke  and
S. Rhys-Williams
A. R. D. Thornton*
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
G. Farrell
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
A. J. Phillips
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
N. P. Haacke
Affiliation:
ENT Department, Royal South Hants Hospital, Graham Road, Southampton, SO9 4PE
S. Rhys-Williams
Affiliation:
ENT Department, Royal South Hants Hospital, Graham Road, Southampton, SO9 4PE
*
Dr A. R. D. Thornton PhD, MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
Get access Rights & Permissions [Opens in a new window]

Abstract

A new objective test of endolymphatic hydrops has been described previously. The test uses auditory brainstem response (ABR) techniques to estimate the basilar membrane travelling wave velocity (TWV). The underlying hypothesis is that raised pressure in the scala media will lead to an increase in the stiffness of the basilar membrane and that this will give rise to a travelling wave velocity that is greater than normal.

It was considered that verification of the technique could be obtained by carrying out the new test before and during a glycerol dehydration procedure. Patients who required this procedure for verification of the diagnosis or as a prognostic indicator for sacculotomy, underwent the following tests. Prior to dehydration an audiogram, the ABR TWV test and a blood sample (for plasma osmolality) were taken. The patient was then given the appropriate amount of glycerol mixed with lemon juice and laid on a bed in a test room. The audiogram and a blood sample were repeated every hour and the ABR TWV test was repeatedly carried out every twenty minutes between the other tests.

Six of these procedures have been carried out. In five of them the 0.5 and 1kHz average threshold improved by at least 10dB and in all those cases the ABR TWV test showed an abnormal pre-dehydration result which moved towards the normal value following dehydration. One patient gave ABR TWV results that were within normal limits before and during the procedure and gave an audiometric change of only 5dB.

These data indicate that the ABR TWV test does detect endolymphatic hydrops. The additional hardware to carry out this test has been constructed and parallel clinical trials at IHR Southampton, Addenbrooke's Hospital, Cambridge, and Queen's Medical Centre, Nottingham, are in hand.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 12 , December 1989 , pp. 1136 - 1139
Copyright
Copyright © JLO (1984) Limited 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Booth, J. B. (1980). Menière's disease: the selection and assessment of patients for surgery using electrocochleography. Annals of the Royal College of Surgeons of England. 62: 415–425.Google ScholarPubMed
Hallpike, C. S. and Cairns, H. (1938). Observations on the pathology of Menière's syndrome. Journal of Laryngology and Otology, 53: 625–655.CrossRefGoogle Scholar
Kanoh, N. and Makimoto, K. (1985). Effects of intravenous glycerol injection on inner ear fluid electrolytes. Acta Otolaryngologica, 99: 46–52.CrossRefGoogle ScholarPubMed
Klockhoff, I., Lindblom, U. and Stahle, J. (1974). Diuretic treatment of Menière's disease. Long-term results with chlorthalidone. Archives of Otolaryngology, 100: 262–268.CrossRefGoogle ScholarPubMed
Klockhoff, I. and Lindblom, U. (1967). Glycerol test in Menière's disease. Acta Otolaryngologica Supplement, 224: 449–456.CrossRefGoogle Scholar
Mori, N., Asai, A., Suizu, Y., Ohta, K. and Matsunaga, T. (1985). Comparison between electrocochleography and glycerol test in the diagnosis of Menière's disease. Scandinavian Audiology, 14: 209–213.CrossRefGoogle ScholarPubMed
Morrison, A. W. (1986). Predictive tests of Menière's disease. American Journal of Otology, 7: 5–10.Google ScholarPubMed
Morrison, A. W., Moffat, D. A. and O'Connor, A. F. (1980). Clinical usefulness of electrocochleography in Menière's disease: An analysis of dehydrating agents. Otolarygologic Clinics of North America, 13: 703–721.CrossRefGoogle ScholarPubMed
Parker, D. J. and Thornton, A. R. D. (1978) Cochlear travelling wave velocities calculated from the derived components of the cochlear nerve and brainstem evoked responses of the human auditory system. Scandinavian Audiology, 7: 67–70.Google ScholarPubMed
Portmann, G. (1927) Vertigo: surgical treatment by opening the saccus endolymphaticus. Archives of Ototolaryngology, 92: 307–310.Google Scholar
Schuknecht, H. F. (1974). Pathology of the Ear. Cambridge, Massachusetts: Harvard University Press.Google Scholar
Schuknecht, H. F. and Gulya, (1983) Endolymphatic hydrops—an overview of classification. Annals of Otology, Rhinology and Laryngology Supplement, 106: 1–20.Google Scholar
Shea, J. (1980). Vasodilator treatment. In Proceedings of the VIth Shambaugh International Workshop in Otomicrosurgery and IIIrd Shea Fluctuant Hearing loss Symposium (Shambaugh, G. and Shea, J., eds.) pp. 279–286. The Strode Publishers Inc.Huntsville, Alabama.Google Scholar
Thornton, A. R. D. and Farrell, G. (1989) Apparent travelling wave velocity changes in cases of endolymphatic hydrops. Scandinavian Audiology (in press).Google Scholar
Tjernstrom, O. and Casselbrant, M. (1981). Pressure chamber treatment in acute attacks of Menière's disease. In Menière's disease (Vosteen, K. H. et al. , ed) p. 211–214. Georg Thieme Verlag, Stuttgart.Google Scholar
Tweed, J. J., Marchbanks, R. J. and Martin, A. M. (1986). The effect of changes in cerebrospinal fluid pressure on the labyrinth in terms of tympanic membrane displacement. ISVR Technical Report, 135.Google Scholar
Ylikoski, M. D., Collan, M. D. and Palva, M. D. (1980). The cochlear nerve in Menière's disease. Archives of Otolaryngology, 106: 393–400.Google ScholarPubMed
Zenner, H. P. (1986). K+—induced motility and depolarization of cochlear hair cells. Direct evidence for a new pathophysiological mechanism in Menière's disease. Archives of Oto-Rhino-Laryngology, 243: 108–111.CrossRefGoogle ScholarPubMed