Abstract
OBJECTIVES: This study aimed to evaluate the diagnostic and staging efficacy of integrating electrocochleography (ECochG) with vestibular function tests-specifically cervical and ocular vestibular evoked myogenic potentials (cVEMP and oVEMP), caloric test (CT), and video head impulse test (vHIT)-for Ménière's disease (MD). DESIGN: Data were collected from 54 MD patients (66 affected ears) admitted to a hospital between January 2023 and January 2024. Each participant underwent pure tone audiometry, ECochG, cVEMP, oVEMP, CT, and vHIT. The results were compared against both established clinical criteria and a newly proposed staging system. Inclusion criteria followed the 2015 diagnostic guidelines for MD. Statistical analyses, including ANOVA, Chi-square, and Kruskal-Wallis H tests, were conducted, and a random forest model was employed to validate the robustness of the proposed staging system. RESULTS: The novel staging system, incorporating vestibular function tests, demonstrated superior sensitivity and diagnostic accuracy compared to traditional audiometry-based staging. Early-stage MD detection improved significantly, with vestibular test abnormalities strongly correlating with disease progression. The overall positive rate for any test was 98.5%. ECochG abnormalities were detected in 54.5% of cases, while cVEMP and oVEMP abnormalities were observed in 75.8% and 69.7% of cases, respectively. The new staging system exhibited a stronger correlation with vestibular dysfunction, effectively identifying functional impairment prior to significant hearing loss. CONCLUSION: The integration of ECochG with vestibular function tests provides a more comprehensive diagnostic framework for MD. This multimodal approach enhances early detection, improves staging accuracy, and offers deeper insights into disease progression, thereby facilitating more personalized treatment strategies.