Lack of diagnostic value of high-pass noise masking of auditory brainstem responses in Ménière's disease.
BACKGROUND
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 Ménière'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.


METHODS
An observational retrospective study.


METHODS
Tertiary referral centre.


METHODS
Forty-five patients, of which 28 patients had MD.


METHODS
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.


METHODS
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.


CONCLUSIONS
In contrast to studies assessing CHAMP performance in Ménière patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Ménière's from non-MD subjects with otovestibular symptoms.
De Valck
Claudia F J
CF
AUREA (Antwerp University Research centre for Equilibrium and Aerospace), University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
Claes
Gerd M E
GM
Wuyts
Floris L
FL
Van de Heyning
Paul H
PH
D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology; D003051:Cochlea; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis / Q000503:physiopathology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology*; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D010470:Perceptual Masking; D012189:Retrospective Studies; D012720:Severity of Illness Index