Frequency-specific Electrocochleography and Traveling Wave Time as a Clinical Test for Menière's Disease

Introduction Meniere's disease is a clinical entity with no definitive objective testing. It has been hypothesized that underlying endolymphatic hydrops stiffens the basilar membrane leading to increased speed of the acoustic stimulus, therefore traveling wave velocity has been proposed as an objective test to aid in the diagnosis. The objective of this study is to compare electrocochleography frequency-specific action potential latency, basilar membrane traveling wave time, and summation to action potential (SP/AP) ratio in Meniere's and non-Meniere's patients. Methods Tympanic electrocochleography was performed with frequency-specific action potential latency time and SP/AP ratio recorded. Patient demographics, symptoms, audiogram data, AAO-HNS classification of Meniere's disease, management interventions, and follow-up were recorded. Statistical analysis was performed to compare outcome measures across patient groups, demographics, and clinical data. Results Ninety-one patients (182 ears) were included. There was a significant difference between a "definite" Meniere's diagnosis and an "unlikely" or "probable" diagnosis by an average of 13 dB HL for the pure-tone thresholds at 250 Hz on the affected side (p = 0.006). There was no significant difference in pure-tone thresholds at any other frequency, AP latency at any frequency, or AP/SP ratio between the different Meniere's classification groups. Conclusions Our study fails to show significance of the traveling wave velocity as an objective test for Meniere's disease. A significant correlation was found with low-frequency hearing loss between AAO-HNS Meniere's classification groups.