Characteristics and Significance of ECochG Changes in Endolymphatic Sac Decompression Surgery
FENG Tianci
YANG Haidi
DENG Wenting
XU Yaodong
TANG Xiaowu
CHEN Ling
HUANG Weiluo
QU Yongkang
Abstract：Objective To report changes of indicator cochleography parameters,i.e.SP/AP amplitude and area under curve ratios,and their potential values in endolymphatic sac decompression(endolymphatic mastoid shunt)for Ménière's disease(MD).Methods A total of 37 patients with unilateral MD who underwent endolymphatic mastoid shunting(EMS)at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from October 2018 to November 2020 were included.Electrocochleography was performed before surgery,during mastoidectomy exposure of the endolymphatic sac,endolymphatic sac incision and drainage,and closure of the surgical cavity.Postoperatively,patients were followed-up for 18 months.Pre-and post-operative pure-tone audiometry(PTA),frequency of vertigo attacks and impact of vertigo on quality of life were compared.Additionally,correlation between SP/AP amplitude and area under curve ratios at various surgical stages and the Dizziness Handicap Index(DHI)scores at 18 months post-surgery,coefficient of vertigo impact on quality of life,and vertigo control outcomes were analyzed.Results At 18 months post-surgery,PTA showed no significant difference compared to before surgery(P>0.05);although the functional,emotional,somatic and total DHI scores were lower(P<0.05).The number of vertigo attacks reached Grade A in 1 case,Grade B in 11 cases,Grade C in 16 cases,and Grade D in 9 cases.The severity of vertigo attacks also decreased compared to pre-operation(P<0.05).No significant changes in SP/AP amplitude and area ratios were noticed during mastoidectomy and labyrinth skeletonization(P>0.05),but decreased ratios were noticed during endolymphatic sac exposure,incision and drainage which persisted during closure of the surgical cavity(P<0.05).The SP/AP intraoperative ratios showed a positive correlation with DHI scores at 18 months,severity of vertigo attacks and vertigo control outcomes(P<0.05).Conclusion EMS can effectively alleviate dizziness in MD,and intraoperative changes in SP/AP amplitude and area ratios have a certain predictive value regarding postoperative recovery outcomes.
Keywords：electrocochleagramMénière's diseaseendolymphatic sac surgeryintraoperative hearing monitoring
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 43-48 )