title: MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Ménière's Disease.
abstract: OBJECTIVE
  To compare the sensitivity of gadolinium MRI inner imaging with tone burst electrocochleography (EcochG) for diagnosing endolymphatic hydrops.
  
  
  METHODS
  A prospective study on patients who were to have an MRI scan to exclude retrocochlear pathology.
  
  
  METHODS
  Tertiary care center.
  
  
  METHODS
  One hundred and two patients: 57 patients with Possible, Probable, or Definite Ménière's Disease, 25 with asymmetrical hearing loss, 18 with sudden sensorineural hearing loss, and 2 with unilateral tinnitus had additional MRI inner ear imaging and click and tone burst stimulus EcochG testing.
  
  
  METHODS
  Diagnostic.
  
  
  METHODS
  To compare the sensitivity of the two techniques.
  
  
  RESULTS
  In 30 patients with symptom-based Definite Ménière's Disease, tone burst EcochG was positive in 25 (83%) and the click EcochG was positive in 9/30 (30%), and gadolinium MRI imaging diagnosed hydrops in 14 (47%). A positive result for either MRI imaging or tone burst EcochG was seen in 26 patients (87%). In 14 subjects with symptom-based Probable Ménière's Disease, 10 (71%) had either a positive EcochG or MRI. In 13 with Possible Ménière's Disease, four (31%) had a positive EcochG or MRI.
  
  
  CONCLUSIONS
  This study confirms the greatly enhanced diagnostic sensitivity of tone burst EcochG over click response in diagnosing endolymphatic hydrops in Ménière's disease. Even though adequate MRI imaging was achieved in 90%, tone burst EcochG was a more sensitive test.
authors.affiliation: Departments of *Otolaryngology-Head and Neck Surgery and †Radiology, Christchurch Hospital, Christchurch; ‡Department of Communication Disorders, University of Canterbury, Christchurch; and §University of Otago, Christchurch, New Zealand.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Hornibrook
authors.forename: Edward
authors.initials: E
authors.lastname: Flook
authors.forename: Sam
authors.initials: S
authors.lastname: Greig
authors.forename: Melissa
authors.initials: M
authors.lastname: Babbage
authors.forename: Tony
authors.initials: T
authors.lastname: Goh
authors.forename: Mark
authors.initials: M
authors.lastname: Coates
authors.forename: Rachel
authors.initials: R
authors.lastname: Care
authors.forename: Philip
authors.initials: P
authors.lastname: Bird
mesh_terms: D000161:Acoustic Stimulation; D001300:Audiometry, Evoked Response / Q000379:methods*; D001301:Audiometry, Pure-Tone; D007758:Ear, Inner / Q000473:pathology*; D018159:Endolymphatic Hydrops / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008575:Meniere Disease / Q000175:diagnosis*; D008875:Middle Aged; D009942:Organometallic Compounds; D011446:Prospective Studies; D014012:Tinnitus / Q000209:etiology; D014722:Vestibule, Labyrinth / Q000473:pathology
chemical_list: D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine