[Electrophysiologic examinations in low frequency hearing impairment: clinical and prognostic aspects].
BACKGROUND
Low-frequency hearing impairment (LFHI) is mainly associated to endolymphatic hydrops and shows a high variety of possible outcomes. Electrophysiologic examinations are widely recommended in diagnostics of LFHI, wheras up to now no data exist about the prognostic value of these examinations in a conservative therapeutic regimen.


METHODS
In a quality assessment, we retrospectively evaluated the records of 90 patients, and performed an audiometric follow-up for analysis of long-time hearing data. All patients had undergone diagnostic electrocochleographic examination (ECochG) and then had been treated with rheologic infusions, followed by dehydrating infusions in patients lacking complete remission. The results of both therapeutic strategies and of long-time results were correlated to electrophysiologic findings.


RESULTS
The prognosis of LFHI is significantly reflected by pretherapeutic electrocochleographic data. All significant parameters were associated to compound action potential (CAP) whereas parameters associated to cochlear microphonics (CM) did not include any utilizable prognostic value. In patients with a good outcome, the latency of CAP complex was significantly shorter, and the width of CAP complex significantly smaller than in patients with poor hearing outcome after rheologic and after dehydrating therapy and in long time assessment. The relation of summating potential (SP) und CAP was significantly smaller when the outcome was sufficient or good for either therapy and in long time analysis. Steep CAP-input-output-curves were associated to insufficient outcome after rheologic therapy and in long time assessment, but not for dehydrating therapy.


CONCLUSIONS
The results indicate that ECochG is of significant prognostic value concerning hearing outcome after conservative therapy in patients suffering from LFHI. It can help the physician to counsel the patient and perform an effective management of the disease. We conclude that ECochG should be performed before the onset of therapy, including collection of SP and CAP data whereas CM parameters may be omitted.
Maier
W
W
Universitäts-HNO-Klinik Freiburg. maier@hno1.ukl.uni-freiburg.de
Aschendorff
A
A
Arapakis
I
I
Klenzner
T
T
Schipper
J
J
D000200:Action Potentials / Q000502:physiology; D000328:Adult; D000368:Aged; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D003055:Cochlear Microphonic Potentials / Q000502:physiology; D003056:Cochlear Nerve / Q000503:physiopathology; D018159:Endolymphatic Hydrops / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010897:Pitch Discrimination / Q000502:physiology; D011379:Prognosis; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values; D012189:Retrospective Studies; D013018:Sound Spectrography; D016896:Treatment Outcome