MRI, Transtympanic EcoGs, and Meniere’s Disease
Hornibrook et al (2015) reported on multiple groups of patients with various otologic diagnosis and the percentage of positive results for magnetic resonance imaging (MRI) with gadolinium contrast, and transtympanic tone burst electrocochleography (TB-EcoG) and transtympanic click-evoked (CE-EcoG) with regard to percentage of correlation with their primary diagnosis.
Of 30 people with “definite Meniere’s,” 14 had a positive result on their MRI with gadolinium, 25 had a positive TB-EcoG, and 9 had a positive CE-EcoG. Of 14 people with “probable Meniere’s,” 4 had a positive result on their MRI with gadolimium, 8 had a positive TB-EcoG, and 4 had a positive CE-EcoG. Of 13 people with “possible Meniere’s,” 1 had a positive result on their MRI, 4 had a positive result TB-EcoG, and 2 had a positive CE-EcoG. In summary, of their 57 patients with various Meniere’s presentations, 37 (65 percent) had positive transtympanic EcoG results. These results are grossly consistent with Ferraro et al (2012) who reported “the sensitivity of this measure (EcoG) appears to hover around 60 percent.”
Hornibrook et al report that Meniere’s studies are often complicated due to the “…high rate of spontaneous symptom improvement and the unpredictable nature of the condition….” Further, they report that “the distribution of endolymphatic hydrops has been shown to often include the cochlear and vestibule irrespective of cochlear-only symptoms or vestibular-only symptoms. Our study shows poor correlation of extent and distribution of hydrops on gadolinium MRI and patient severity of Meniere’s symptoms…some patients can have EcoG changes indicating endolymphatic hydrops in the cochlea but without changes being identified on gadolinium MRI…” and they suspect EcoG as a “more sensitive” indicator of inner ear dysfunction than MRI.
Note: Unfortunately, as there were no “normal hearing” control groups used, these results cannot be considered “hit rates” for Meniere’s Disease (across the general population) with regard to MRI, EcoG, and the Meniere’s categories above.
For More Information, References, and Recommendations
Ferraro J, Beck DL, Speidel DP. (2012) Developments in Electrocochleography. Hearing Review May 31.
Hornibrook J, Flook E, Greig S, Babbage M, Goh T, Coates M, Care R, Bird P. (2015) MRI Inner Ear Imaging and Tone Burst Electrocochleography in the Diagnosis of Meniere’s Disease. Otology & Neurotology 36:1109–1114.