Abstract：
OBJECTIVE: To evaluate the diagnostic role of combined electrocochleography and pure-tone audiometry monitoring during dehydrating test in Ménière\'s disease and consider its suitability as a diagnostic tool to differentiate those patients with unclear differential diagnosis and therefore identify those with clear endolymphatic hydrops responsive to dehydrating test. To study the efficacy of dehydrating therapy on vertiginous symptoms and hearing loss in patients with Ménière\'s disease.
METHODS: Prospective case series.
METHODS: University hospital, secondary referral center.
METHODS: Thirty patients, 20 women and 10 men, age range of 25 to 75 years, matching the criteria for definite Ménière\'s disease according to the Barany Society classification.
METHODS: Diagnostic. During an active phase of the disease, electrocochleography and pure-tone audiometry were performed, and repeated at 30th, 45th, and 60th minutes after intramuscular injection of 40 mg furosemide and 40 mg methylprednisolone.
METHODS: Data related to symptoms, electrocochleography, and pure-tone audiometry during the dehydrating test were collected at different times and statistically analyzed.
RESULTS: After the administration of dehydrating therapy, we observed that both summating potential and action potential ratio and summating potential and action potential area ratio were normalized in 21 of 30 subjects. Furthermore, pure-tone audiometry thresholds improved significantly. An improvement of ear fullness was also observed, whereas tinnitus unchangeably persisted.
CONCLUSIONS: The monitoring of the electrocochleography and pure-tone audiometry thresholds during dehydrating tests with furosemide and methylprednisolone could allow to detect an improvement of instrumental features and clinical symptoms related to endolymphatic hydrops, and therefore, it could be used as a diagnostic tool in the identification of those patients affected by Ménière\'s disease with unclear differential diagnosis.
METHODS: Prospective case series.
METHODS: University hospital, secondary referral center.
METHODS: Thirty patients, 20 women and 10 men, age range of 25 to 75 years, matching the criteria for definite Ménière\'s disease according to the Barany Society classification.
METHODS: Diagnostic. During an active phase of the disease, electrocochleography and pure-tone audiometry were performed, and repeated at 30th, 45th, and 60th minutes after intramuscular injection of 40 mg furosemide and 40 mg methylprednisolone.
METHODS: Data related to symptoms, electrocochleography, and pure-tone audiometry during the dehydrating test were collected at different times and statistically analyzed.
RESULTS: After the administration of dehydrating therapy, we observed that both summating potential and action potential ratio and summating potential and action potential area ratio were normalized in 21 of 30 subjects. Furthermore, pure-tone audiometry thresholds improved significantly. An improvement of ear fullness was also observed, whereas tinnitus unchangeably persisted.
CONCLUSIONS: The monitoring of the electrocochleography and pure-tone audiometry thresholds during dehydrating tests with furosemide and methylprednisolone could allow to detect an improvement of instrumental features and clinical symptoms related to endolymphatic hydrops, and therefore, it could be used as a diagnostic tool in the identification of those patients affected by Ménière\'s disease with unclear differential diagnosis.
摘要：
目的：评估在脱水试验期间联合耳蜗电图和纯音测听监测对梅尼埃病的诊断作用，并考虑其作为一种诊断工具的适用性，以区分那些鉴别诊断不明确的患者，从而确定那些对脱水试验有反应的明确内淋巴积水。研究脱水疗法对梅尼埃病患者眩晕症状和听力损失的疗效。
方法：前瞻性病例系列。
方法：大学医院，二级转诊中心。
方法：30名患者，20个女人和10个男人,年龄范围为25至75岁，根据BaranySociety分类，匹配确定的梅尼埃病标准。
方法：诊断。在疾病的活跃阶段，进行了耳蜗电图和纯音测听，并在30号重复，45岁，肌肉注射40mg呋塞米和40mg甲基强的松龙后60分钟。
方法：与症状相关的数据，耳蜗电图,收集脱水试验中不同时间的纯音测听并进行统计学分析。
结果：脱水治疗后，我们观察到，在30名受试者中，有21名受试者的求和电位和动作电位比率以及求和电位和动作电位面积比率均归一化。此外，纯音测听阈值显着提高。还观察到耳朵丰满度的改善，而耳鸣持续不变。
结论：使用呋塞米和甲基强的松龙进行脱水试验期间监测耳蜗电图和纯音测听阈值可以检测与内淋巴积水相关的仪器特征和临床症状的改善，因此,该方法可作为一种诊断工具,用于鉴别诊断不明确的梅尼埃病患者。
方法：前瞻性病例系列。
方法：大学医院，二级转诊中心。
方法：30名患者，20个女人和10个男人,年龄范围为25至75岁，根据BaranySociety分类，匹配确定的梅尼埃病标准。
方法：诊断。在疾病的活跃阶段，进行了耳蜗电图和纯音测听，并在30号重复，45岁，肌肉注射40mg呋塞米和40mg甲基强的松龙后60分钟。
方法：与症状相关的数据，耳蜗电图,收集脱水试验中不同时间的纯音测听并进行统计学分析。
结果：脱水治疗后，我们观察到，在30名受试者中，有21名受试者的求和电位和动作电位比率以及求和电位和动作电位面积比率均归一化。此外，纯音测听阈值显着提高。还观察到耳朵丰满度的改善，而耳鸣持续不变。
结论：使用呋塞米和甲基强的松龙进行脱水试验期间监测耳蜗电图和纯音测听阈值可以检测与内淋巴积水相关的仪器特征和临床症状的改善，因此,该方法可作为一种诊断工具,用于鉴别诊断不明确的梅尼埃病患者。
