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American Journal of Audiology Vol.8 21-28 June 1999. doi:10.1044/1059-0889(1999/001)
© American Speech-Language-Hearing Association
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SP/AP Area Ratio in the Diagnosis of Ménière's Disease

John A. Ferraro 1 and Richard P. Tibbils 1

1 University of Kansas Medical Center

jferraro{at}kumc.edu

Conventional analysis of the click-evoked electrocochleogram includes measurement of the amplitudes of the cochlear summating potential (SP) and auditory nerve action potential (AP) to derive the SP/AP amplitude ratio. It is now well documented that an amplitude ratio where SP is elevated relative to AP may be a positive finding for endolymphatic hydrops in patients suspected of having Meniere's disease (MD). However, the incidence of an elevated SP/AP amplitude ratio in the general MD population is only ap60%. This relatively low value necessitates efforts to improve the diagnostic sensitivity of electrocochleography (ECochG) for MD. A review of early and more recent literature in this area indicates that consideration of both the amplitude and duration of ECochG components may help to achieve this goal. The present study combined these features to measure the "area" of the SPAP complex in normal and MD populations. A software routine was used to measure the amplitude x duration area of the SP-AP complex in (a) normally hearing adults with normal SP/AP amplitude ratios (Group 1), (b) confirmed MD patients with elevated SP/AP amplitude ratios (Group 2), and (c) probable MD patients with normal SP/AP amplitude ratios (Group 3). Ninety percent of the confirmed MD patients in Group 2 displayed elevated SP/AP area ratios relative to the normative value established from Group 1. In addition, almost half of the probable MD patients from Group 3 displayed elevated area ratios. These findings indicate that measurement of the SP/AP area ratio holds promise for improving the sensitivity of ECochG in the diagnosis of MD.

Key Words: ECochG, SP, AP, amplitude ratio, area ratio, Ménière's disease, endolymphatic hydrops

Submitted on November 18, 1997
Accepted on December 22, 1998


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Home page
 Arch Otolaryngol Head Neck SurgHome page
A. K. Devaiah, K. L. Dawson, J. A. Ferraro, and G. A. Ator
Utility of Area Curve Ratio Electrocochleography in Early Meniere Disease
Arch Otolaryngol Head Neck Surg, May 1, 2003; 129(5): 547 - 551.
[Abstract] [Full Text] [PDF]


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