Supplementary Material for: The Diagnostic Value of Multifrequency Tympanometry in Patients with Ménière’s Disease: A Prospective Analysis

Introduction: Diagnosing Ménière’s disease (MD) by its characteristics such as episodes of vertigo, fluctuating hearing loss, and tinnitus with aural fullness remains challenging. Available tests evaluating the presence of endolymphatic hydrops (EH) are often expensive or time assuming. An in-office quick and simple non-invasive diagnostic test is multifrequency tympanometry (MFT). It can measure conductance at 2 kHz probe tones, which was demonstrated to reflect variations in cochlear pressure. Previous studies investigating MFT as a diagnostic test for MD showed conflicting outcomes possibly biased by their retrospective design. Methods: We prospectively collected MFT results (Y width) in patients with dizziness and compared MFT test results in affected (group 1) and unaffected (group 2) ears of 37 MD subjects and in control ears of 33 non-MD subjects (group 3). Results: The mean value of the Y width in affected ears was 315.6 ± 70.2 daPa compared to 292.3 ± 98.6 daPa in unaffected ears in MD subjects and 259.4. ± 60.6 daPa in the non-MD group. A positive test result (i.e., a Y width of 235 daPa or more) was found in 35 ears in the MD group, 21 times involving the affected ear and 14 times involving the unaffected ear, compared to 16 in the non-MD group. No significant differences between the three groups could be demonstrated (p > 0.05). We found a sensitivity of 58.3% and specificity of 66.3% for detecting EH in an affected ear in MD subjects. Conclusion: There is a trend towards increased conductance tympanometry in affected ears. However, we noticed a high false positive rate of MFT and do not support standardized use of MFT as an additional diagnostic tool for detecting EH in MD patients. A negative test result on the contrary is unlikely related to EH.

引言：基于眩晕发作、波动性听力损失以及伴耳胀满感的耳鸣等特征诊断梅尼埃病（Ménière’s disease, MD）仍颇具挑战。用于评估内淋巴积水（endolymphatic hydrops, EH）是否存在的现有检测手段往往成本高昂或耗时较长。多频鼓室图（multifrequency tympanometry, MFT）是一种可在诊室开展的快速、简便且无创的诊断检测手段，该检测可测量2kHz探测音下的导纳值，此前研究已证实该值可反映耳蜗压力的变化情况。既往将MFT作为MD诊断手段的相关研究结果存在分歧，这可能受其回顾性研究设计的影响而存在偏倚。
方法：本研究前瞻性收集了眩晕患者的MFT检测结果（Y宽度），并对比了37名MD受试者的患耳（第1组）、健耳（第2组）以及33名非MD受试者的对照耳（第3组）的MFT检测结果。
结果：MD受试者患耳的Y宽度平均值为315.6±70.2 daPa，健耳为292.3±98.6 daPa，而非MD组的平均值为259.4±60.6 daPa。MD组中共35耳出现检测结果阳性（即Y宽度≥235 daPa），其中21耳为患耳、14耳为健耳；而非MD组中仅有16耳出现阳性结果。三组间未观察到显著统计学差异（p>0.05）。针对MD受试者患耳的EH检测，本研究得到的灵敏度为58.3%，特异度为66.3%。
结论：患耳的鼓室导纳检测值存在升高的趋势。但本研究发现MFT的假阳性率较高，因此不支持将MFT作为检测MD患者EH的标准化辅助诊断工具。反之，检测结果阴性则不太可能与EH相关。