Possible Effects of Cochlear Hydrops and Related Phenomena

ABSTRACT

There is some question in the literature concerning the effects of hydrops on otoacoustic emissions (OAEs), and the usefulness of OAE measurement in the differential diagnosis of Ménière's disease and related disorders remains unclear. It is reasonable to expect different effects in various cochlear pathologies, especially between those causing primarily low-frequency (LF) versus high-frequency (HF) hearing losses, as typically associated with putative fluid mechanical lesions versus hair cell damage, respectively. We report observations on distortion product OAEs in patients with LF and combinations of LF and HF losses and discuss problems of relating DPOAE output to the LF ``hydrops'' audiogram. We then describe effects specifically of intralabyrinthine pressure on OAEs, a possible factor in hydrops. It is clear from results in the literature and in our own clinics and laboratories that OAEs are sensitive to intralabyrinthine static pressure. These measures may or may not accurately reflect the hydrops hearing loss. The results are thus complex, doubtlessly reflecting the complexity and dynamics of diseases such as Ménière's. On the other hand, the effect of intralabyrinthine pressure per se is predictable and can be demonstrated to be rather predictable in humans.

KEYWORD

Otoacoustic emissions - cochlear function - hair cells - Ménière's disease - hydrops - intracochlear pressure - cerebrospinal fluid - middle-ear function - stapes

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