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  • Title: A comparison of three methods of using transtympanic electrocochleography for the diagnosis of Meniere's disease: click summating potential measurements, tone burst summating potential amplitude measurements, and biasing of the summating potential using a low frequency tone.
    Author: Iseli C, Gibson W.
    Journal: Acta Otolaryngol; 2010; 130(1):95-101. PubMed ID: 19396716.
    Abstract:
    CONCLUSION: Stimulus biasing modulated the amplitude of the tone burst evoked summating potential (SP) in ears affected by Meniere's disease less than in normal ears. A reduced SP bias ratio added diagnostic accuracy for the diagnosis of Meniere's disease. OBJECTIVES: To evaluate the effect of stimulus biasing on the human tone burst SP, and to determine if stimulus biasing could contribute to the electrocochleography as a means of confirming the diagnosis of Meniere's disease. PATIENTS AND METHODS: Patients referred for transtympanic electrocochleography (TT ECochG) were assessed prospectively on clinical grounds according to the AAO-HNS criteria and a scale devised by one of the authors. A Meniere's group of ears and a non-Meniere's group of ears was determined. The ears opposite a Meniere's ear were not included in the analysis. The ratio of the click SP amplitude and the action potential (AP) amplitude (SP/AP ratio), the tone burst SP amplitude at 500 Hz,1 kHz, 2 kHz and 8 kHz, and the effect of stimulus biasing on the tone burst SP were measured. RESULTS: A unipolar stimulus biasing ratio established for the modulation of the 1 kHz tone burst SP separated the Meniere's ears from the non-Meniere's ears with a sensitivity of 85% at a specificity of 80.6% and the difference between groups reached statistical significance (p=0.016). The 1 kHz SP amplitude measurements and the stimulus biasing measurements were superior to the click SP/AP ratio for identifying the Meniere's group. A combination of 1 kHz SP amplitude measurements and SP bias ratio separated the Meniere's ears from the non-Meniere's ears with an accuracy of 85%.
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