耳蜗电图在梅尼埃病诊断中的价值

迄今尚缺乏诊断梅尼埃病的敏感且特异的客观试验，７０年代以来，若干研究探讨了耳蜗电图（Ｅｌｅｃｔｒｏｃｏｃｈｌｅｏｇｒａｍ，ＥＣｏｃｈＧ）在梅尼埃病诊断中的价值，认为典型的改变是－ＳＰ异常增大，导致－ＳＰ／ＡＰ比值增高，以及－ＳＰ－ＡＰ复合波形异常增宽。各家报告－ＳＰ／ＡＰ诊断梅尼埃病阳性率从３２％至８７％．本文报告了９７例１００耳梅尼埃病鼓室内法检测的耳蜗电图结果，４９例－ＳＰ／ＡＰ比值异常增高，阳性率４９％；波型异常增宽１７耳，总阳性率６６％．眼震电图检测的阳性率６１％．耳蜗电图和眼震电图改变一致的４３耳，二者总阳性率为８４％。对各家阳性率不一致的原因作了分析。认为耳蜗电图－ＳＰ／ＡＰ比值诊断梅尼埃病的敏感性不如文献报告的那么乐观，在目前尚无更敏感更特异的诊断手段的情况下，耳蜗电图和眼震电图在梅尼埃病的诊断中起着相互印证和相互补充的作用。

Diagnostic Value of Transtympanic Electrocochleography in Meniere's Disease

Electrocochleography(ECochG) has been considered a valuable objective test in the diagnosis of Meniere's disease for more than 20 years,as electronystagmography(ENG) and sinosoidal harmonic acceleration test have not shown characteristic vestibular deficit patterns.This study reviewed ECochG results from 100 ears of 97 patients with Meniere's disease,Abnormal ECochG was seen in 66 ears(66%).Increased -SP/AP ratios were seen in 49 ears(49%)and broadened CAP waveforms in 17 ears(17%).Sensitivity of ECochG in diagnosing Meniere's disease seems not as high as reported in some papers.Possible explanations are discussed.Comparison of ECochG and ENG results suggests that the former are supplementary and confirmative to the latter in the diagnosis of Meniere's disease.