Intratympanic Electrocochleography (ECoG) — Can It Damage My Hearing or Worsen Tinnitus?

Yesterday, my ENT asked me to have an intratympanic electrocochleography (ECoG) to rule out whether I might have Meniere's disease.

I have never had dizziness, nor do I have hearing loss up to 8 kHz. However, there may be a possibility that the Meniere's disease is in early stages.

Should I proceed with the ECoG? I heard that it can be as loud as 90 dB.

 

They told me that the sound can go up to 100 dB and that the test lasts for 2 hours.

Since I had hyperacusis and loud tinnitus at that moment, I postponed the test. It seemed too much for me to handle.

 

Is the exam 2 hours straight listening to 100 dB? Does it take so long?

 

I have a friend whose tinnitus worsened a lot with this exam. It is often used to diagnose hydrops but some ENT consider it inconclusive.

 

They told me that there would be some pauses, you are not hearing the sounds all the time. Maybe you should ask your doctor for more details before making a decision.

 

Sounds like a one way ticket to hell.

 

OMG, I don't know what to do!

 

Calm down.

Talk to your doctor, ask everything you want to know.

If you don't feel like doing it now, you can wait for a few days/weeks.

 

No harm in waiting and thinking about it a bit.

 

Why does your ENT want to do the test if you do not have some of the key symptoms (dizziness and hearing loss after 8 kHz)?

There are a lot of conditions that you could be in the early stages for without any symptoms, doctors do not typically test for those things without solid reasoning. Though some doctors seem to recommend testing if they suspect the results will be normal but feel the test results will give the patient peace of mind.

If you had this test and it found early stages of Meniere’s Disease, what would be the next step? Would it entirely prevent progression or is it inevitable?

Is this the only test used to identify/rule out Meniere’s Disease?

 

I personally wouldn’t do it.

 

No ENT has measured my hearing above 8 kHz, but below 8 kHz I have no hearing loss.

By the way, does anyone know if SPI-1005 will slow down the progression of Meniere's disease?
I see that this drug is in Phase 3, and they had good results in the previous phases.

The ENT said that ECoG done with an intratympanic needle is accurate, while the one that is not invasive has false positives and false negatives.

I think it's better to take the test, because I can't sleep thinking about whether I have Meniere's disease or not.

I forgot to mention, I have no dizziness.

Just tinnitus.

In the consultation I did 2 months ago, he prescribed me Flunarizine and it helped me, the tinnitus went down. He only mentioned ECoG when I said that the medication was good for me.

 

In my honest opinion, with regards to the previous posters, I think the chances of them finding Ménière's to be the cause of your problems are very slim, while the risk of permanently worsening your problems are greater.

Do you have any symptoms of Ménière's at all?

 

Cannot Ménière's-like vestibular issues be ruled out with other procedures that do not involve blasting sounds in the ears? The website of Mayo Clinic lists six different diagnostic procedures for the balance assessment, and five of them do not seem to involve loud noises. Also, it says "ECoG looks at the inner ear in response to sounds. It might help to determine if there is an abnormal buildup of fluid in the inner ear, but isn't specific for Meniere's disease."

I would be very careful.

 

With no dizziness and no hearing loss, why you would test? Only because a medication decreased your tinnitus? I would take that as a plus and move on.

If you’re testing because you think you have a condition — despite not having the key symptoms — then the root of your desire for this test is more grounded in anxiety versus symptoms.

I can relate to wanting to understand why we have a health condition. I underwent extensive testing after losing my hearing. But I did so because of symptoms, and my doctors always talked about risks versus benefits. As a previous poster pointed out, there are less evasive ways to rule out Meniere’s Disease. Why not start there?

 

Take an 8-16 kHz audiogram first.

 

I may have misunderstood, is a symptom of Meniere’s Disease hearing loss above or below 8 kHz? Loss above 8 kHz is normal as we age.

 

My vestibular therapist wants me to do an ECoG and I said no thanks. He said it was safe lol. I have suspected hydrops, random dizziness (not vertigo), tinnitus that changes, ear pain and fullness (random) and high sodium in my blood. F**k the test.

 

Oh sorry, you’re probably correct. It’s usually (?) below 8 kHz. I just wanted to point out a safer road of tests before doing something regrettable.

 

Hello everybody. The ENT said ECoG is safe and that hundreds of people take this test daily. I actually don't have any symptoms anymore, like vertigo, hearing loss below 8 kHz, but now I can't even sleep well because the ENT told me it was a possibility and wanted to rule it out. Do you think I can ask them to lower the test volume? Or would it affect effectiveness of the test?

I've already asked to do a hearing test above 8 kHz but they won't let me, because it's normal for everyone to have hearing loss above these frequencies.

 

Could you ask the ENT what kind of treatment they could offer if it turns out that they think it's Meniére's based on the ECoG? Is there anything which is proven to be effective to slow down or stop progression? I only read about diuretics, diet, gentamicin injections into the ear or severing one of the muscles in the middle ear, but the last one is supposed to be effective - based on anecdotal evidence - for only dizziness and vertigo attacks.

Do you think the risk of worsening a potential Meniére's is greater than worsening your tinnitus? Is time is of essence in this situation? Do you risk an irreversible negative progression, if you wait more to do the test to see wether more typical M's symptoms present themselves?

I'd also be very careful. What seems to be totally safe from a doctor's perspective may not be so much for a tinnitus sufferer's perspective. I was told for example that MRI is absolutely safe because small children go through with it every single day without issues, but for me it did turn out problematic.

 

He sounds arrogant and very sat in his ways. Get a new ENT.

 

Lowering the test frequencies would likely compromise the test results, and leave you worried that the results you receive are not accurate.

Is your doctor an ENT or an neurotologist? Can you get a second opinion?

Anxiety and not Meniere’s Disease symptoms are driving your focus on this test. There are other test options for individuals with symptoms.

 

From what I understand the diagnostic relevance of electrocochleography is not so clear. I spoke with 4 ENTs and only one thought it could tell us something important. I have a friend whose tinnitus went from mild to severe due to the test. Of course you always find someone for whom a test or a medication can worsen things but in the case of this test there has been more than one report.

Kriszti above has a good point. Would the test results be actionable and lead to rapid intervention, given that your symptoms subsided? Could it guide the therapy? For example, I had a blood test that turned positive and then the specialist didn't know what to do with it.

One way out could be asking a second opinion to a different specialist to see if he recommends it too. In one case one ENT wanted to put grommets in my ear, but I visited a second one who inspected my Eustachian tubes with a camera and told me it would be useless, so i didn't do it.

 

** Update **

My appointment (and the test) is on Thursday. I'm going to ask them to do it only with low level sounds. I won't let them do up to 90 dB.

So it's less likely to make my tinnitus worse.

I didn't really want to do the test, but I think I should trust the doctor to rule out possible hypotheses.

 

I asked the same question, if they could do it with low level sounds.
They said it was possible (going up to maximum 90 dB), but they weren't very sure about the outcome.

I also asked about the possibility of aggravating the tinnitus. They didn't know what to tell me about that either. In theory it could happen, but they said that there hadn't been any complaints of this kind.

Considering the lot of ifs, I decided to wait a little big longer.
I don't say that this was the correct thing to do, but for me at that moment it was the only option.

You, on the other side, could give it a try.
After all, you can and you should stop any time you feel that the sound is too loud.

 

90 dB is not considered harmful to hearing if listened to for a few minutes.

It's hard for me to believe that the test is as bad as it looks and they just keep sending people there.

Did you say the test would last 2 hours? 2 hours of listening to noises?

 

Yes, they told me that the test will last for 2 hours and there will be some pauses.
But maybe it is somehow different in your case?
You have to ask them what will happen during the test.

I wouldn't count on that...
This loudness level might be ok for healthy people, but in our case, with our condition...

Give it a try. If it's too loud, just stop. I'll probably do it in a few weeks/months.

 

Today was exam day.

I was very scared, because my tinnitus could get worse.

Piercing the eardrum is not pleasant. The sounds were about 30 seconds each, at 100 dB, 90 dB and 50 dB.

My tinnitus didn't change and the exam was fine. So the exam went well.

 

I'm glad for you that everything turned out to be ok.

What about the results of the test? What did they tell you?