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Verification of a new test of endolymphatic hydrops

Published online by Cambridge University Press:  29 June 2007

A. R. D. Thornton ,
G. Farrell ,
A. J. Phillips ,
N. P. Haacke  and
S. Rhys-Williams
A. R. D. Thornton*
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
G. Farrell
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
A. J. Phillips
Affiliation:
MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
N. P. Haacke
Affiliation:
ENT Department, Royal South Hants Hospital, Graham Road, Southampton, SO9 4PE
S. Rhys-Williams
Affiliation:
ENT Department, Royal South Hants Hospital, Graham Road, Southampton, SO9 4PE
*
Dr A. R. D. Thornton PhD, MRC Institute of Hearing Research, Royal South Hants Hospital, Graham Road, Southampton SO9 4PE
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Abstract

A new objective test of endolymphatic hydrops has been described previously. The test uses auditory brainstem response (ABR) techniques to estimate the basilar membrane travelling wave velocity (TWV). The underlying hypothesis is that raised pressure in the scala media will lead to an increase in the stiffness of the basilar membrane and that this will give rise to a travelling wave velocity that is greater than normal.

It was considered that verification of the technique could be obtained by carrying out the new test before and during a glycerol dehydration procedure. Patients who required this procedure for verification of the diagnosis or as a prognostic indicator for sacculotomy, underwent the following tests. Prior to dehydration an audiogram, the ABR TWV test and a blood sample (for plasma osmolality) were taken. The patient was then given the appropriate amount of glycerol mixed with lemon juice and laid on a bed in a test room. The audiogram and a blood sample were repeated every hour and the ABR TWV test was repeatedly carried out every twenty minutes between the other tests.

Six of these procedures have been carried out. In five of them the 0.5 and 1kHz average threshold improved by at least 10dB and in all those cases the ABR TWV test showed an abnormal pre-dehydration result which moved towards the normal value following dehydration. One patient gave ABR TWV results that were within normal limits before and during the procedure and gave an audiometric change of only 5dB.

These data indicate that the ABR TWV test does detect endolymphatic hydrops. The additional hardware to carry out this test has been constructed and parallel clinical trials at IHR Southampton, Addenbrooke's Hospital, Cambridge, and Queen's Medical Centre, Nottingham, are in hand.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 12 , December 1989 , pp. 1136 - 1139
Copyright
Copyright © JLO (1984) Limited 1989

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