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. 2022 Dec 25;8(1):262-268.
doi: 10.1002/lio2.998. eCollection 2023 Feb.

Impact of endolymphatic hydrops on DPOAE in subjects with normal to mild hearing loss

Kei Inagaki  1 , Tadao Yoshida  1 , Masumi Kobayashi  1 , Satofumi Sugimoto  1 , Yukari Fukunaga  2 , Daisuke Hara  2 , Shinji Naganawa  3 , Michihiko Sone  1
Affiliations

Impact of endolymphatic hydrops on DPOAE in subjects with normal to mild hearing loss

Kei Inagaki et al. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: The increased endolymph volume affects a shift in the organ of Corti and basilar membrane in ears with endolymphatic hydrops (EH), which might affect distortion-product otoacoustic emissions (DPOAE) by altering the operating point of the outer hair cells. We investigated how changes in DPOAE are related to the distribution site of EH.

Study design: Prospective study.

Methods: Among 403 patients with hearing or vestibular symptoms who underwent contrast-enhanced magnetic resonance imaging (MRI) for the diagnosis of EH and subsequent DPOAE testing, subjects whose hearing levels on pure tone audiometry were ≤35 dB at all frequencies were included in this study. In patients with EH on MRI, the presence and amplitude of DPOAE were evaluated between groups with hearing levels of ≤25 dB at all frequencies versus hearing levels of >25 dB at one or more frequencies.

Results: There were no differences in the distribution of EH between groups. The amplitude of DPOAE had no clear correlation with the presence of EH. However, in both groups, there was a significantly higher probability of the presence of a DPOAE response from 1001 to 6006 Hz in cases with EH in the cochlea.

Conclusion: Among patients whose hearing levels were ≤35 dB at all frequencies, better responses on DPOAE testing were found in subjects with EH in the cochlea. Alteration of DPOAEs in the early stages of hearing impairment could indicate morphological changes in the inner ear with altered basilar membrane compliance due to EH.

Level of evidence: 4.

Keywords: Meniere's disease; distortion‐product otoacoustic emissions; endolymphatic hydrops; magnetic resonance imaging.

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Conflict of interest statement

The authors have no sources of funding, financial relationships, or conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Sample images using hybrid of reversed image of positive endolymph signal and native image of positive perilymph signal (HYDROPS) images of the left ears included in this study. From left to right: no hydrops, mild hydrops, and significant hydrops. The arrows indicate endolymphatic hydrops in the cochlea; arrowheads indicate endolymphatic hydrops in the vestibule
FIGURE 2
FIGURE 2
SNR of DPOAE by frequency. Comparison of SNR for each frequency between Groups 1 and 2. Group 1 was the group with hearing levels ≤25 dB at all frequencies, and Group 2 was the group with hearing levels >25 to ≤35 dB at one or more frequencies. Symbols and thin bars indicate mean and ± 1 standard deviation values, respectively. **Statistical significance (defined as p < .01), ***statistical significance (defined as p < .001). DPOAE, distortion‐product otoacoustic emissions; SNR, signal‐to‐noise ratio
FIGURE 3
FIGURE 3
SNR of DPOAE by frequency. Comparison of SNR for each frequency with and without endolymphatic hydrops in Group 1. (Hearing levels ≤25 dB at all frequencies.) DPOAE, distortion‐product otoacoustic emissions; SNR, signal‐to‐noise ratio
FIGURE 4
FIGURE 4
SNR of DPOAE by frequency. Comparison of SNR for each frequency with and without endolymphatic hydrops in Group 2. (Hearing levels >25 to ≤35 dB at one or more frequencies.) DPOAE, distortion‐product otoacoustic emissions; SNR, signal‐to‐noise ratio
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