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Thirty patients with Menière's disorder, 11 patients with cochlear hearing loss of other aetiologies and 10 normally-hearing subjects, were investigated using transtympanic electrocochleography (TT ECochG). Alternating polarity clicks, condensation and rarefaction clicks and long tone-bursts of 1 kHz were used for stimulation. The latencies of the AP responses to click stimulation were evaluated. It was found that the latency differences between the condensation and rarefaction click-evoked responses were significantly larger in patients with Menière's disorder as compared to normal subjects and to patients with other cochlear hearing losses. It was found that the sensitivity of TT ECochG, obtained by using measurements of SP-AP ratios and the SP amplitude at 1 kHz burst stimulation, increased from 83 per cent to 87 per cent by addition of the con-rar shift measurement. The specificity of TT ECochG obtained by this combination of variables was 100 per cent in our material. The results of the study indicate that the latency shift found in responses evoked by clicks of opposite polarities in TT ECochG, can be a useful parameter in the detection of suspected endolymphatic hydrops.

The reproducibility of transtympanic electrocochleographic components was investigated in normal-hearing subjects and in patients with Menière's disease. The electric responses to short clicks and long tone bursts were studied using repeated stimuli within the same test (intratest), and after replacement of all electrodes (intertest). The parameters of the response to clicks, such as the SP/AP (summating potential/action potential) ratio and the width of the complex as well as the amplitudes of the response to clicks presented at fast repetition rate, were analyzed. Absolute amplitudes of the SP were measured using long tone bursts of 4, 2 and 1 kHz. It was found that the intratest reproducibility of the responses was good for all the parameters. The intertest responses showed a larger variability, particularly when long bursts were used. Parameters obtained from hydroptic ears, which could be considered mainly representative for the SP, showed the largest variability of the responses. The effect of replacement of the electrodes amounted to less than 35% of the total intertest variability which would indicate that replacement of the electrodes did not significantly influence the recordings obtained at different measurement occasions in the same patient. The upper normal limit value indicating changes which could be contributed to biological fluctuations and the method of measurements were calculated for each response parameter. Changes exceeding these values could thus be attributed to a real change in the electric cochlear potentials, at the 95% confidence level.

The response of the perilymphatic fluid to complex pressure waves, composed of low-frequency sine waves superimposed on square-wave pressure pulses of varying amplitude was studied. In cats with a patent cochlear aqueduct a pronounced positive pressure change could be induced in the perilymphatic fluid when complex pressure waves were used. The time constants associated with the stabilization of the perilymphatic pressure after the application of pressure complexes were longer than those associated with square-wave pulses alone. The results indicate that the functional patency of the cochlear aqueduct could be influenced by the transmission of complex pressure waves. The results also indicate that when trying to influence the inner ear hydrodynamic balance in patients with Meniere's disease, the effect of complex pressure waves is far superior to the effect of square-wave pressure pulses in patients with an open cochlear aqueduct.

The perilymphatic (PP) and cerebrospinal fluid (PCSF) pressures were investigated in relation to pressure variations in the ear canal, middle ear and intracranial compartment before and after occlusion of the cochlear aqueduct (CA). Experiments using intracranial infusion showed that the CA was responsible for a perfect hydrodynamic balance between the CSF and the perilymph. There are indications of additional pressure release factors but their capacities were not sufficient to prevent the appearance of a longstanding and substantial pressure gradient following occlusion of the CA. A gradual PP build-up, from zero to its original level after the CA was opened and occluded, indicated perilymph production within the labyrinth. Investigation of pressure transfer from the ear canal and middle ear to the perilymph showed that the CA was the major pressure release route from the cochlea. Occlusion of the CA reduced the compliance of the inner ear and severely reduced the pressure release capacity. In such a situation the inner ear is almost incapable of equilibrating ambient pressure changes.