單側梅尼爾氏病之鼓膜外耳蝸電圖與患側之符合程度

Correlation between Extratympanic Electrocochleography and Disease Side in Unilateral Meniere's Disease

黃俊豪(Juen-Haur Hwang) ； 林怡君(Yi-Chun Lin) ； 李清池(Qing-Chih Lee) ； 蕭士軒(Shih-Hsuan Hsiao) ； 何旭爵(Hsu-Chueh Ho)

《台灣耳鼻喉頭頸外科雜誌》 44卷2期 (2009/04) Pp. 46-50

https://doi.org/10.6286/2009.44.2.46

摘要

背景：鼓膜外耳蝸電圖可用來診斷梅尼爾氏病，不過它的結果與患病側符合的程度，目前並不清楚，因此本研究探討此一議題。
方法：我們回溯分析128名接受鼓膜外耳蝸電圖檢查之眩暈病患。這些病患分爲兩組，一組是確定或極可能是單側梅尼爾氏病之患者，另一組爲疑似或非梅尼爾氏病之患者。所有梅尼爾氏病患者之聽力圖，皆屬於上昇型或低頻聽力喪失型。另外，以多變數線性迴歸分析性別、年齡、平均聽力，對於鼓膜外耳蝸電圖結果的影響。
結果：單側梅尼爾氏病患者有68名(右側有33名，左側有35名)，疑似或非梅尼爾氏病患者有60名。有70.6% (48/68)之梅尼爾氏病患者，加重電位與動作電位比值(SP/AP ratio)大於或等於0.42，而疑似(possible)或非梅尼爾氏病患者中，只有30.0% (18/60)升高。在梅尼爾氏病患者中，SP/APratio升高者，有35.4% (17/48)顯現在同側，43.8% (21/48)顯現在兩側，有20.8% (10/48)在對側。此外，在所有單側梅尼爾氏病患者中，只有60.3% (41/68)之SP/AP ratio，屬於同側大於對側。根據傳統的絕對診斷標準(SP/AP≧0.42)，鼓膜外耳蝸電圖陽性的結果，只有79.2% (38/48)和疾病的患側相符合。此外，以多變數線性迴歸分析，SP/AP ratio並不會明顯受到性別、年齡、或平均聽力的影響。
結論：鼓膜外耳蝸電圖的結果與患病側並不完全符合。此外，性別、年齡、或平均聽力，對SP/AP ratio的影響並不顯著。

關鍵字

耳蝸電圖 ； 鼓膜外 ； 梅尼爾氏病

並列摘要

BACKGROUND: Extratympanic electrocochleography (ECoG) can offer objective information in diagnosing Meniere's disease. But, correlation between its results and disease side was not clear. Therefore, in this study, we tried to investigate this issue.
METHODS: We conducted a retrospective analysis of 128 vertiginous patients who underwent extratympanic ECoG examinations and hearing tests in our outpatient department. All patients were divided into 2 groups: the ”definite/probable Meniere's disease” (MD) group, and the ”possible and non-Meniere's vertigo disease (non-MD) group.” The audiogram of the MD group belonged to either the upward-sloping type or low-frequency hearing loss pattern unilaterally. A multivariate linear regression was performed on extratympanic ECoG results by sex, age, and the mean hearing level.
RESULTS: Our study included 68 cases in the MD group and 60 cases in the non- MD group. An elevated summating potential/action potential (SP/AP) ratio (≧0.42) was noted in 70.6% (48/68) of the MD group and 30.0% (18/60) of the non-MD group. In the MD group, an elevated SP/AP ratio was noted in 35.4% (17/48) of the ipsilateral side, 43.8% (21/48) of both sides, and 20.8% (10/48) of the contralateral side. In addition, only 60.3% (41/68) patients of the MD group presented with a higher SP/AP ratio in the ipsilateral side. A uniform result could be derived only between a positive extratympanic ECoG result and side of disease in 79.2% (38/48) subjects by conventional absolute criterion (SP/AP≧0.42). In addition, SP/AP ratio was not affected significantly by mean hearing level of low frequencies, sex and age by multivariate linear regression analysis.
CONCLUSIONS: The results of extratympanic ECoG were not consistent well with the side of disease in unilateral MD. In addition, SP/AP ratio was not affected significantly by mean hearing level of low frequencies, sex and age by multivariate linear regression analysis.

並列關鍵字

electrocochleography ； extratympanic ； Meniere's disease