A Systematic Review of Electrocochleography (ECochG) in Ménière’s Disease Diagnosis

Abstract

Objectives:

Electrocochleography (ECochG) is an objective test that can be used in the diagnosis of Ménière’s Disease (MD). This study 1) reviews the sensitivity and specificity of non-invasive ECochG in articles reporting on MD diagnosis over the past 10 years; 2) determines the non-invasive ECochG test parameters that increase the test’s sensitivity in MD diagnosis.

Methods:

An extensive search of Medline, the Cochrane library, EBASE, Web of Science, and Google Scholar was performed. Only English language articles published from 2002 to 2012 that diagnosed Ménière’s disease based on the 1995 American Academy of Otolaryngology—Head and Neck Surgery criteria were included. The Oxford Centre for Evidence-Based Medicine (March 2009) levels of evidence were adopted.

Results:

The most widely used diagnostic criteria show the click induced SP/AP amplitude ratio provides approximately 53-70% sensitivity and 80-90% specificity (evidence level 2). Combining click and tone burst induced ECochG derived measurement parameters SP/AP area ratio, latencies shift, amplitude ratio, and interaural SP/AP ratio provide approximately 84-92% sensitivity with a specificity of approximately 85-90% (evidence level 2).

Conclusions:

ECochG diagnostic specificity for MD is 80-90%; however, the 53-70% sensitivity of ECochG can be increased to 84-92% by combining multiple measurements derived from click and tone burst ECochG.