| ObjectiveThe purpose of this study was to investigate and compare the clinical significance of the three methods in the assessment of different stages in patients with Meniere's disease by studying the parameters of the electrocochleography,caloric test and the video head impulse test.MethodsA total of 70 cases(70 ears)of unilateral Meniere's disease were diagnosed in the First Affiliated Hospital of Zhengzhou University from February 2019 to January 2020.According to the different hearing threshold,the all cases were divided into four stages:the first stage(mean hearing threshold ?25 dBHL),the second stage(mean hearing threshold 26?40 dBHL),the third stage(mean hearing threshold 41-70 dBHL),and the fourth stage(mean hearing threshold in excess of 70 dBHL).The pure tone test,electrocochleography,caloric test and the video head impulse test were performed in 70 patients and the parameters were recorded.The control group consisted of 25 healthy volunteers(50 ears)with normal hearing.SP amplitude,AP amplitude,SP/AP amplitude ratio and area ratio were recorded and compared between Meniere's disease group and control group.The mean values of SP amplitude,SP/AP amplitude ratio and area ratio in Meniere's Disease group and healthy control group were compared by independent sample t test.The difference was statistically significant(P<0.05).Chi-square test was used to compare the abnormal detection rates of electrocochleography,caloric test and the video head impulse test,positive rate of SP/AP amplitude ratio and area ratio,caloric test and the video head impulse test in patients with Meniere's disease,the difference was statistically significant with P<0.05.ResultsThe number of the different stages in patients with Meniere's disease is 15 cases,24 cases,21 cases,10 cases.The mean values of SP amplitude,AP amplitude,SP/AP amplitude ratio and area ratio in Meniere's disease group were respectively(0.807±0.306)?V,(1.552±0.441)?V,(0.430±0.099),(2.157±0.364).The normal control group were respectively(0.393±0.131)?V,(1.154±0.464)?V,(0.281±0.080),(1.490±0.274).SP amplitude,SP/AP amplitude ratio and area ratio in Meniere's disease group were higher than those of the normal control group(P<0.05).The abnormal rate of electrocochleography was 46.67%in the first stage,second and third stages of Meniere's disease respectively was 75.00%and 80.95%.The number of the abnormal of electrocochleography of the fourth stage was 2,so no analysis.The abnormal rate of caloric test was 40.00%,70.83%,80.95%and 90.00%,respectively,and the abnormal rate of the video head impulse test was 13.33%,37.50%,47.62%and 60.00%,respectively,the total abnormal rate of the three tests increased with Meniere's disease's stage of hearing.Conclusions1.SP/AP area ratio as an evaluation parameter of electrocochleography had more advantages in the diagnosis of Meniere's disease.2.The results of electrocochleography were affected by many factors,such as the choice of reference value standard,the location of electrodes,the choice of stimulus sound,the stage and group differences of Meniere's disease and so on.3.The positive rate of the three tests increased with the degree of hearing impairment,which indicated that the degree of vestibular function impairment is positively correlated with the degree of cochlear function impairment in Meniere's patients.4.The caloric test and the video head impulse test can comprehensively analyze the low frequency and high frequency injury of horizontal semicircular canal in patients with Meniere's disease.The caloric test and electrocochleography can evaluate the changes of semicircular canal and cochlear function in patients with Meniere's disease. |
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