Electrocochleography Evaluation in the Diagnosis of Meniere's Disease

Yeşim Gizem Ertürk; Ceren Uğur; Muhammed Pınar

doi:10.37989/gumussagbil.1607867

Review

Electrocochleography Evaluation in the Diagnosis of Meniere's Disease

Year 2025, Volume: 14 Issue: 2, 832 - 839, 26.06.2025

Yeşim Gizem Ertürk , Ceren Uğur , Muhammed Pınar

https://doi.org/10.37989/gumussagbil.1607867

Abstract

Abstract

Meniere's disease is a heterogeneous disease of the audiovestibular system, etiologically caused by endolymphatic hydrops, accompanied by both vestibular and auditory symptoms. Various evaluation methods can be used in the diagnosis of the disease. Some of these are; Pure tone audiometry, otoacoustic emissions, Electrocochleography (EcochG), vestibular evoked myogenic potentials and magnetic resonance imaging. Electrocochleography is a testing method that allows the assessment of cochlear electrical potentials. The primary condition diagnosed by ECochG and available for neuromonitoring intraoperatively is Meniere's disease. In Meniere's disease, the magnitude of the summation potential (SP) increases with the impairment of the transduction process, while the action potential (AP) will remain relatively constant. This condition causes an increased SP/AP ratio and is pathophysiologically associated with endolymphatic hydrops. The aim of our study is to investigate the role and worth of EcochG in the clinical diagnosis of Meniere's disease according to the studies conducted in the current literature. Pubmed and Web of Science database was used for our review study. The search words used to examine the studies in between 2014-2024 were determined as ''ECochG, Meniere's disease''. In this context, a total of 126 studies were reached. 9 research articles and 4 systematic reviews were included, including the role of Electrocochleography in the diagnosis of Meniere's disease and its evaluation results. It is thought that the EcochG test method alone will not be sufficient in the diagnosis of Meniere's disease and that examining it together with other evaluation methods will guide clinicians to a more accurate and reliable diagnosis.

Keywords

Electrocochleography, Meniere's disease, Endolymphatic hydrobs, Otoacoustic emissions, Hearing loss

References

1. Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, et al. Meniere's disease. Nat Rev Dis Primers. 2016;2(1):1-18. https://doi.org/10.1038/nrdp.2016.28
2. Agrawal Y, Ward BK, Minor LB. Vestibular dysfunction: prevalence, ımpact and need for targeted treatment. J Vestib Res. 2013;23(3):113. https://doi.org/10.3233/VES-130498
3. Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R, et al. Clinical practice guideline: ménière’s disease executive summary. Otolaryngol Head Neck Surg. 2020;162(4):415-34. https://doi.org/10.1177/0194599820909439
4. Evren C, Demirbilek N, Küfeciler L. Odyometri Atlası. İstanbul: Nobel Tıp Kitabevleri: 2021.
5. Roy B, Sur M. Vestibular rehabilitation in patients with meniere's disease: current trends and future directions. IJSA. 2024;5(1):13-19. https://doi.org/10.22271/27103846.2024.v5.i1a.44
6. Mohseni-Dargah M, Falahati Z, Pastras C, Khajeh K, Mukherjee P, Razmjou A, et al. Meniere's disease: pathogenesis, treatments, and emerging approaches for an ıdiopathic bioenvironmental disorder. Environ Res. 2023;11:69-72. https://doi.org/10.1016/j.envres.2023.116972
7. Foster CA, Breeze RE. Endolymphatic hydrops in ménière’s disease: cause, consequence, or epiphenomenon? Otol Neurotol. 2013;34(7):1210-14. https://doi.org/10.1097/MAO.0b013e31829e83df
8. Okuno H & Watanabe I. Audiological findings of prolonged meniere's disease. auris nasus larynx. 1990;17(3):157-63. https://doi.org/10.1016/s0385-8146(12)80076-9
9. Swain SK. Current treatment of meniere's disease. Matrix Sci Medica. 2023;7(1):1-6. https://doi.org/10.4103/mtsm.mtsm_8_22
10. Cumpston E, Totten DJ, Hohman MH. Electrocochleography. Treasure Island. StatPearls Publishing: 2024
11. Harris MS, Koka K, Riggs WJ, Saleh S, Holder JT, Dwyer RT, et al. Can electrocochleography help preserve hearing after cochlear ımplantation with full electrode ınsertion? Otol Neurotol. 2022;43(7):789-96. https://doi.org/10.1097/MAO.0000000000003588
12. Goodman SS, Lichtenhan JT, Jennings SG. Minimum detectable differences in electrocochleography measurements: bayesian-based predictions. J Assoc Res Otolaryngol. 2023;24(2):217-37. https://doi.org/10.1007/s10162-023-00888-0
13. Gibson WP. The clinical uses of electrocochleography. Front Neurosci. 2017;11:274. https://doi.org/10.3389/fnins.2017.00274
14. Coraci LM, Beynon AJ. Use of an extra-tympanic membrane electrode to record cochlear microphonics with click, tone burst and chirp stimuli. Audiol Res. 2021;11(1):89-99. https://doi.org/10.3390/audiolres11010010
15. Kumar P, Peepal P. Electrocochleography in individuals with Meniere’s disease. Indian Journal of Otology. 2012;18(2):72–75. https://doi.org/10.4103/0971-7749.100713
16. Lefler SM, Kaf WA, Ferraro JA. Comparing simultaneous electrocochleography and auditory brainstem response measurements using three different extratympanic electrodes. J Am Acad Audiol. 2021;32(6):339-46. https://doi.org/10.1055/s-0041-1727273
17. Liu H, Zhou K, Zhang X, Peng KA. Fluctuating sensorineural hearing loss. Audiol Neurotol. 2019;24(3):109-16. https://doi.org/ 10.1159/000500658
18. Ishii M, Tanaka H, Asai R, Kanai Y, Kato Y, Ito Y, et al. New non‐contrast mrı of endolymphatic hydrops in ménière's disease considering ınversion time. Laryngoscope Investig Otolaryngol. 2024;9(4):e1314. https://doi.org/10.1002/lio2.1314
19. Radua J. PRISMA 2020-An updated checklist for systematic reviews and meta-analyses. Neurosci Biobehav Rev. 2021;124:324-325. https://doi.org/10.1016/j.neubiorev.2021.02.016
20. Lamounier P, Gobbo DA, Souza TS, Oliveira CA, Bahmad F Jr. Electrocochleography for ménière’s disease: ıs ıt reliable? Braz J Otorhinolaryngol. 2014;80(6):527-32. https://doi.org/10.1016/j.bjorl.2014.08.010
21. Oh KH, Kim KW, Chang J, Jun HS, Kwon EH, Choi JY, et al. Can we use electrocochleography as a clinical tool in the diagnosis of meniere’s disease during the early symptomatic period? Acta Oto-Laryngologica. 2014; 134(8):771-5. https://doi.org/10.3109/00016489.2014.907500
22. Hornibrook J, Flook E, Greig S, Babbage M, Goh T, Coates M, et al. MRI ınner ear ımaging and tone burst electrocochleography in the diagnosis of ménière’s disease. Otol Neurotol. 2014;36(6):1109-14. https://doi.org/10.1097/MAO.0000000000000782
23. Gerenton G, Giraudet F, Djennaoui I, Pavier Y, Gilain L, Mom T, et al. Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in menière's disease. Hear Res. 2015. https://doi.org/10.1016/j.heares.2015.07.016
24. Ziylan F, Smeeing DP, Stegeman I, Thomeer HG. Click stimulus electrocochleography versus mrı with ıntratympanic contrast in ménière's disease: a systematic review. Otology & Neurotology. 2016;37(5):421-27. https://doi.org/10.1097/MAO.0000000000001021
25. Lamounier P, de Souza TSA, Gobbo DA, Bahmad Jr F. Evaluation of vestibular evoked myogenic potentials (vemp) and electrocochleography for the diagnosis of ménière’s disease. Braz Journal of Otorhinolaryngology. 2016; 83(4):394-403. https://doi.org/10.1016/j.bjorl.2016.04.021
26. Mammarella F, Zelli M, Varakliotis T, Eibenstein A, Pianura CM, Bellocchi G. Is electrocochleography still helpful in early diagnosis of meniere disease? J Audiol Otol. 2017;21(2):72-76. https://doi.org/10.7874/jao.2017.21.2.72
27. Ciorba A, Skarżyński PH, Corazzi V, Bianchini C, Aimoni C, Hatzopoulos S. Assessment tools for use in patients with ménière disease: an update. Med Sci Monit. 2017;28(23):6144-49. https://doi.org/10.12659/msm.905166
28. Quatre R, Attyé A, Karkas A, Job A, Dumas G, Schmerber S, et al. Relationship between audio-vestibular functional tests and ınner ear mrı in meniere’s disease. Ear Hear. 2019;20(1):168-76. https://doi.org/10.1097/AUD.0000000000000584
29. Ayub A, Qi L, Nunez DAA. Systematic Review and meta-analysis of extratympanic electrocochleography in ménière’s disease diagnosis. International Journal of Audiology. 2019;58(9):533-40. https://doi.org/ 10.1080/14992027.2019.1606947
30. Obeidat FS, Lewis Bell S. Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of ménière’s disease. International Journal of Audiology. 2019;58(11):738-46. https://doi.org/10.1080/14992027.2019.1627008
31. Martines F, Dispenza F, Montalbano C, Priola R, Torrente A, La Gumina R, et al. Comparison of electrocochleography and video head ımpulse test findings in vestibular migraine and ménière disease: a preliminary study. J Int Adv Otol. 2020;16(2):183-89. https://doi.org/10.5152/iao.2020.8165
32. Bawazeer N, Gagnon C, Maheu M, Saliba I. Click sp/ap area ratio versus tone burst sp amplitude to diagnose ménière's disease using electrocochleography. Otolaryngol Head Neck Surg. 2024;171(2):494-501. https://doi.org/10.1002/ohn.693

Meniere Hastalığı Tanısında Elektrokokleografi Değerlendirmesi

Year 2025, Volume: 14 Issue: 2, 832 - 839, 26.06.2025

Yeşim Gizem Ertürk , Ceren Uğur , Muhammed Pınar

https://doi.org/10.37989/gumussagbil.1607867

Abstract

Özet
Meniere hastalığı, hem vestibüler hem işitsel semptomların eşlik ettiği, etiyolojik olarak endolenfatik hidrobsun sebep olduğu odyovestibüler sistemin heterojen bir hastalığıdır. Hastalığın tanısında çeşitli değerlendirme yöntemleri kullanılabilir. Bunlardan bazıları; Saf ses odyometri, otoakustik emisyon, Elektrokokleografi (EcochG), vestibüler uyarılmış miyojenik potansiyeller ve manyetik rezonans görüntülemedir. Elektrokokleografi, koklear elektriksel potansiyelleri değerlendirmeyi sağlayan bir test yöntemidir. ECochG tarafından teşhis edilen ve intraoperatif olarak nöromonitörizasyon için kullanılabilen birincil durum meniere hastalığıdır. Meniere hastalığında, sumasyon potansiyeli (SP) büyüklüğü transdüksiyon sürecindeki bozulma ile artarken, aksiyon potansiyeli (AP) nispeten sabit kalacaktır. Bu durum artmış SP/AP oranına sebebiyet vermektedir ve patofizyolojik olarak endolenfatik hidrobs ile ilişkilendirilmektedir. Çalışmamızın amacı, EcochG’nin meniere hastalığı klinik tanısında güncel literatürde yapılmış olan araştırmalarca rolü ve değerinin incelenmesidir. Derleme çalışmamız için Pubmed ve Web of Science veritabanı kullanıldı. Çalışmamız kapsamında 2014-2024 yılları arasındaki çalışmaları incelemek amacıyla kullanılan arama sözcükleri ’’ECochG, meniere disease’’ şeklinde belirlendi. Bu kapsamda toplam 126 çalışmaya ulaşıldı. Meniere hastalığının tanısında Elektrokokleografinin rolü ve değerlendirme sonuçlarını içeren 9 araştırma makalesi ve 4 sistematik derleme dahil edildi. EcochG test yönteminin meniere hastalığı tanısında tek başına yeterli olmayacağı ve diğer değerlendirme yöntemleri ile birlikte incelenmesinin klinisyenleri daha doğru ve güvenilir tanıya yönlendireceği düşünülmektedir.

Keywords

Elektrokokleografi, Meniere Hastalığı, Endolenfatik hidrobs, Otoakustik emisyon, İşitme kaybı

References

1. Nakashima T, Pyykkö I, Arroll MA, Casselbrant ML, Foster CA, Manzoor NF, et al. Meniere's disease. Nat Rev Dis Primers. 2016;2(1):1-18. https://doi.org/10.1038/nrdp.2016.28
2. Agrawal Y, Ward BK, Minor LB. Vestibular dysfunction: prevalence, ımpact and need for targeted treatment. J Vestib Res. 2013;23(3):113. https://doi.org/10.3233/VES-130498
3. Basura GJ, Adams ME, Monfared A, Schwartz SR, Antonelli PJ, Burkard R, et al. Clinical practice guideline: ménière’s disease executive summary. Otolaryngol Head Neck Surg. 2020;162(4):415-34. https://doi.org/10.1177/0194599820909439
4. Evren C, Demirbilek N, Küfeciler L. Odyometri Atlası. İstanbul: Nobel Tıp Kitabevleri: 2021.
5. Roy B, Sur M. Vestibular rehabilitation in patients with meniere's disease: current trends and future directions. IJSA. 2024;5(1):13-19. https://doi.org/10.22271/27103846.2024.v5.i1a.44
6. Mohseni-Dargah M, Falahati Z, Pastras C, Khajeh K, Mukherjee P, Razmjou A, et al. Meniere's disease: pathogenesis, treatments, and emerging approaches for an ıdiopathic bioenvironmental disorder. Environ Res. 2023;11:69-72. https://doi.org/10.1016/j.envres.2023.116972
7. Foster CA, Breeze RE. Endolymphatic hydrops in ménière’s disease: cause, consequence, or epiphenomenon? Otol Neurotol. 2013;34(7):1210-14. https://doi.org/10.1097/MAO.0b013e31829e83df
8. Okuno H & Watanabe I. Audiological findings of prolonged meniere's disease. auris nasus larynx. 1990;17(3):157-63. https://doi.org/10.1016/s0385-8146(12)80076-9
9. Swain SK. Current treatment of meniere's disease. Matrix Sci Medica. 2023;7(1):1-6. https://doi.org/10.4103/mtsm.mtsm_8_22
10. Cumpston E, Totten DJ, Hohman MH. Electrocochleography. Treasure Island. StatPearls Publishing: 2024
11. Harris MS, Koka K, Riggs WJ, Saleh S, Holder JT, Dwyer RT, et al. Can electrocochleography help preserve hearing after cochlear ımplantation with full electrode ınsertion? Otol Neurotol. 2022;43(7):789-96. https://doi.org/10.1097/MAO.0000000000003588
12. Goodman SS, Lichtenhan JT, Jennings SG. Minimum detectable differences in electrocochleography measurements: bayesian-based predictions. J Assoc Res Otolaryngol. 2023;24(2):217-37. https://doi.org/10.1007/s10162-023-00888-0
13. Gibson WP. The clinical uses of electrocochleography. Front Neurosci. 2017;11:274. https://doi.org/10.3389/fnins.2017.00274
14. Coraci LM, Beynon AJ. Use of an extra-tympanic membrane electrode to record cochlear microphonics with click, tone burst and chirp stimuli. Audiol Res. 2021;11(1):89-99. https://doi.org/10.3390/audiolres11010010
15. Kumar P, Peepal P. Electrocochleography in individuals with Meniere’s disease. Indian Journal of Otology. 2012;18(2):72–75. https://doi.org/10.4103/0971-7749.100713
16. Lefler SM, Kaf WA, Ferraro JA. Comparing simultaneous electrocochleography and auditory brainstem response measurements using three different extratympanic electrodes. J Am Acad Audiol. 2021;32(6):339-46. https://doi.org/10.1055/s-0041-1727273
17. Liu H, Zhou K, Zhang X, Peng KA. Fluctuating sensorineural hearing loss. Audiol Neurotol. 2019;24(3):109-16. https://doi.org/ 10.1159/000500658
18. Ishii M, Tanaka H, Asai R, Kanai Y, Kato Y, Ito Y, et al. New non‐contrast mrı of endolymphatic hydrops in ménière's disease considering ınversion time. Laryngoscope Investig Otolaryngol. 2024;9(4):e1314. https://doi.org/10.1002/lio2.1314
19. Radua J. PRISMA 2020-An updated checklist for systematic reviews and meta-analyses. Neurosci Biobehav Rev. 2021;124:324-325. https://doi.org/10.1016/j.neubiorev.2021.02.016
20. Lamounier P, Gobbo DA, Souza TS, Oliveira CA, Bahmad F Jr. Electrocochleography for ménière’s disease: ıs ıt reliable? Braz J Otorhinolaryngol. 2014;80(6):527-32. https://doi.org/10.1016/j.bjorl.2014.08.010
21. Oh KH, Kim KW, Chang J, Jun HS, Kwon EH, Choi JY, et al. Can we use electrocochleography as a clinical tool in the diagnosis of meniere’s disease during the early symptomatic period? Acta Oto-Laryngologica. 2014; 134(8):771-5. https://doi.org/10.3109/00016489.2014.907500
22. Hornibrook J, Flook E, Greig S, Babbage M, Goh T, Coates M, et al. MRI ınner ear ımaging and tone burst electrocochleography in the diagnosis of ménière’s disease. Otol Neurotol. 2014;36(6):1109-14. https://doi.org/10.1097/MAO.0000000000000782
23. Gerenton G, Giraudet F, Djennaoui I, Pavier Y, Gilain L, Mom T, et al. Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in menière's disease. Hear Res. 2015. https://doi.org/10.1016/j.heares.2015.07.016
24. Ziylan F, Smeeing DP, Stegeman I, Thomeer HG. Click stimulus electrocochleography versus mrı with ıntratympanic contrast in ménière's disease: a systematic review. Otology & Neurotology. 2016;37(5):421-27. https://doi.org/10.1097/MAO.0000000000001021
25. Lamounier P, de Souza TSA, Gobbo DA, Bahmad Jr F. Evaluation of vestibular evoked myogenic potentials (vemp) and electrocochleography for the diagnosis of ménière’s disease. Braz Journal of Otorhinolaryngology. 2016; 83(4):394-403. https://doi.org/10.1016/j.bjorl.2016.04.021
26. Mammarella F, Zelli M, Varakliotis T, Eibenstein A, Pianura CM, Bellocchi G. Is electrocochleography still helpful in early diagnosis of meniere disease? J Audiol Otol. 2017;21(2):72-76. https://doi.org/10.7874/jao.2017.21.2.72
27. Ciorba A, Skarżyński PH, Corazzi V, Bianchini C, Aimoni C, Hatzopoulos S. Assessment tools for use in patients with ménière disease: an update. Med Sci Monit. 2017;28(23):6144-49. https://doi.org/10.12659/msm.905166
28. Quatre R, Attyé A, Karkas A, Job A, Dumas G, Schmerber S, et al. Relationship between audio-vestibular functional tests and ınner ear mrı in meniere’s disease. Ear Hear. 2019;20(1):168-76. https://doi.org/10.1097/AUD.0000000000000584
29. Ayub A, Qi L, Nunez DAA. Systematic Review and meta-analysis of extratympanic electrocochleography in ménière’s disease diagnosis. International Journal of Audiology. 2019;58(9):533-40. https://doi.org/ 10.1080/14992027.2019.1606947
30. Obeidat FS, Lewis Bell S. Comparing the sensitivity and specificity of cervical vestibular-evoked myogenic potentials and electrocochleography in the diagnosis of ménière’s disease. International Journal of Audiology. 2019;58(11):738-46. https://doi.org/10.1080/14992027.2019.1627008
31. Martines F, Dispenza F, Montalbano C, Priola R, Torrente A, La Gumina R, et al. Comparison of electrocochleography and video head ımpulse test findings in vestibular migraine and ménière disease: a preliminary study. J Int Adv Otol. 2020;16(2):183-89. https://doi.org/10.5152/iao.2020.8165
32. Bawazeer N, Gagnon C, Maheu M, Saliba I. Click sp/ap area ratio versus tone burst sp amplitude to diagnose ménière's disease using electrocochleography. Otolaryngol Head Neck Surg. 2024;171(2):494-501. https://doi.org/10.1002/ohn.693

There are 32 citations in total.

Details

Primary Language	English
Subjects	Allied Health and Rehabilitation Science (Other)
Journal Section	Derlemeler
Authors	Yeşim Gizem Ertürk 0000-0002-9526-4417 Ceren Uğur 0009-0004-3191-4208 Muhammed Pınar 0000-0002-0899-5298
Publication Date	June 26, 2025
Submission Date	January 1, 2025
Acceptance Date	April 20, 2025
Published in Issue	Year 2025 Volume: 14 Issue: 2

Cite

APA	Ertürk, Y. G., Uğur, C., & Pınar, M. (2025). Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 14(2), 832-839. https://doi.org/10.37989/gumussagbil.1607867
AMA	Ertürk YG, Uğur C, Pınar M. Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease. Gümüşhane Sağlık Bilimleri Dergisi. June 2025;14(2):832-839. doi:10.37989/gumussagbil.1607867
Chicago	Ertürk, Yeşim Gizem, Ceren Uğur, and Muhammed Pınar. “Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14, no. 2 (June 2025): 832-39. https://doi.org/10.37989/gumussagbil.1607867.
EndNote	Ertürk YG, Uğur C, Pınar M (June 1, 2025) Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14 2 832–839.
IEEE	Y. G. Ertürk, C. Uğur, and M. Pınar, “Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease”, Gümüşhane Sağlık Bilimleri Dergisi, vol. 14, no. 2, pp. 832–839, 2025, doi: 10.37989/gumussagbil.1607867.
ISNAD	Ertürk, Yeşim Gizem et al. “Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 14/2 (June 2025), 832-839. https://doi.org/10.37989/gumussagbil.1607867.
JAMA	Ertürk YG, Uğur C, Pınar M. Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease. Gümüşhane Sağlık Bilimleri Dergisi. 2025;14:832–839.
MLA	Ertürk, Yeşim Gizem et al. “Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, vol. 14, no. 2, 2025, pp. 832-9, doi:10.37989/gumussagbil.1607867.
Vancouver	Ertürk YG, Uğur C, Pınar M. Electrocochleography Evaluation in the Diagnosis of Meniere’s Disease. Gümüşhane Sağlık Bilimleri Dergisi. 2025;14(2):832-9.

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