[Diagnosis of labyrinth hydrops in patients on different stages of Meniere's disease].

Abstract

Objective: To calculate the sensitivity (Se) and specificity (Sp) indicators of clinical and instrumental diagnostic methods of labyrinth hydrops (LH) in patients with definite Meniere's disease (MD, according to the EAONO classification, 2015).

Materials: We examined 67 patients with definite MD: stage 1 - 24, stage 2 - 23, stage 3 - 20 patients, as well as 30 subjects with sensorineural hearing loss (control group) with tone hearing thresholds similar to those in patients with MD.

Study methods: Clinical, otorhinolaryngological, otoneurological (using audiometric and vestibulometric tests) examinations, extratympanic electrocochleography, glycerol dehydration test. Statistical analysis of obtained results was performed with Statistica software package (version 10.0.1011).

Results: It has been established that Se and Sp indicators of clinical and instrumental tests in patients with definite MD and confirmed LH depend on the disease stage according to neurovisualization data. Electrocochleography, audiometric curve type (ascending) and dehydration test are the most sensitive and specific for detection of LH at the first stage of MD (96%); electrocochleography, ultrasound audiometry, caloric and video impulse tests (their dissociation) - at the second stage of MD (96%); audiometric curve type (horizontal), caloric and video impulse tests and vHIT (their dissociation), registration of cervical vestibular evoked myogenic potentials (their asymmetry) - at the third stage of MD (95%).

Conclusions: The obtained results allow to optimize the diagnostic algorithm at suspicion on LH, as well as to reduce economic costs by eliminating test with low sensitivity and weak informativity.