Cochlear Hydrops Analysis Masking Procedure(CHAMP)의 원리

서지정보

ㆍ발행기관 : 한국청각언어재활학회 ㆍ수록지정보 : 청능재활 / 3권 / 2호
ㆍ저자명 : 김진숙

목차

INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSIONS AND CONCLUSIONS
REFERENCES

한국어 초록

메니에르 질병의 가장 중요한 병리생리학적 근거는 사후 부검을 통한 측두엽의 조직 병리학적 분석으로 증명될 수 있는 내림프 수종이다. 임상적으로 나타나는 증상은 현훈, 가변적 청력손실, 이명, 귀가 꽉 찬 느낌의 이충만감 혹은 이압박감 등으로 요약할 수 있으나 이명이나 이충만감 중 적어도 하나는 존재하여야 진단을 내릴 수 있는 것으로 알려져 있다. 이러한 임상적 증상을 근거로 1995년 American Academy of otolaryngology-Head and Neck Surgery (AAO-HNS)는 메니에르 질병을 네 가지 진단척도-certain (확실한), definite(뚜렷한), probable(개연성 있는), possible (가능성 있는)-로 분류하였다.3) 이 중 20분 이상 지속되는 일시적인 현훈이 2회 이상, 적어도 1회 이상 청력검사로 검증된 청력손실, 이명이나 이충만감이 수반된‘뚜렷한’ 경우와 그러한 뚜렷한 경우의 증상에 조직 병리학적인 증거가

영어 초록

Recently, Cochlear Hydrops Analysis Masking Procedure (CHAMP), simply analyzing technique from the stacked auditory brainstem response (ABR), proved to be able to separate normal control from definite Ménière’s disease groups. CHAMP test is based on the hypothesis that the cochlear hydrops alter the mechanical properties of the basilar membrane. Cochlear hydrops or endolymphatic hydrops results in increased traveling wave velocity and a basalward shift in the peak of the traveling wave in cochleas with presumed normal basilar membrane elasticity. This alteration of the properties can be found in patients diagnosed with Ménière’s disease because the underlying pathophysiologic state in Ménière’s disease is endolymphatic hydrops and causes impaired high-pass noise (HPN) masking of auditory brainstem responses to clicks. When the ABR response were obtained from the click alone and click with 8, 4, 2, 1, 0.5 kHz HPN masking conditions, the cochlea is successively masked from 8 kHz and higher and down to 0.5 kHz higher, the peak
latency of wave V usually increases with restricted response region. However, in Ménière’s disease patients, the masking noise does reduce the amount of neural activity, the noise does not mask sufficiently the high frequency regions of the cochlea that dominate the latency measure. This response pattern where the latency of wave V changes little as the cochlea is progressively masked from 8 to 0.5 kHz is referred to the undermasked pattern. The undermasked component in the response to clicks with 0.5 kHz HPN masking and wave V in the response to clicks presented alone clearly distinguished between normal and Ménière’s disease groups with less than 0.3 ms ‘wave V latency delay’ in the latter group. Considering the difficulty of determining the undermasked component, ‘complex amplitude ratio’, the ratio of the amplitude of wave V in the subtracted waveform (click alone-0.5 kHz HPN) to the amplitude of wave V in the response to clicks alone was also developed. Although more investigations are needed for utilizing clinically CHAMP seems to be valuable tool for discriminating active Ménière’s disease in individuals objectively with high sensitivity and specificity.

KEY WORDS：Endolymphatic hydrops·Me´nie`re’s disease·High pass noise (HPN)·The undermasked pattern·Cochlear Hydrops Analysis Masking Procedure (CHAMP).

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