The authors proposed multifrequency tympanometry (MFT) as an in-office test which may be able to diagnose Ménière’s disease (MD) that is quicker and more cost-effective than other methods. MFT measures the acoustic admittance of the middle ear and external ear canal at a wide range of frequencies. It can measure conductance at 2 kHz probe tones, which was demonstrated to reflect variations in cochlear pressure. Previous MFT studies have had conflicting outcomes in regard to its diagnostic capabilities. The authors designed a prospective cross-sectional study in patients who presented to a single centre (Apeldoorn Dizziness Centre) between 2016 to 2018. MD-was diagnosed following vestibular investigation using the diagnostic criteria described by Lopez-Escamez et al (2015). Seventy patients were identified: 32 definite and five probable MD, and 33 other subjects with other cause of dizziness. In 15 ears, the MFT failed and four cases of MD were bilateral. Y (admittance) width at 2 kHz was recorded with the width of double peaks created during testing used to identify endolymphatic hyrdrops. Results revealed mean value of Y width in MD affected ears of 315 +/- 70.2 daPA, 292.83 +/- 98.6 daPA in unaffected ears of MD participants, and 259.4 +/- 60.6 daPA in non-MD group. No statistical difference was demonstrated (p>0.05). Sensitivity was 58.3% and specificity was 66.3%. In conclusion, there is a trend towards increased conductance in the affected ears of those with MD. However, there is also a significant high false-positive rate and the authors do not support standardised use of MFT as a diagnostic tool. In addition, there is suspected inter/intravariability in conducting MFT (even when performed by the same technician on the same subject). I feel this is a useful paper to consider novel techniques, however not currently appropriate for in-office use.
Can tympanometry be used to diagnose Ménière’s disease?
Reviewed by Aaron Ferguson
