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The Sunnybrook facial grading system (SFGS) is one of the most widely employed tools to assess facial function. The present study aimed to determine the validity and reliability of the Spanish language version of the SFGS.Forward-backward translation from the original English version was performed by fluent speakers of English and Spanish. Videos from 65 patients with facial paralysis (FP) were evaluated twice by five otolaryngologists with experience in FP evaluation. Internal consistency and intra- and inter-rater reliability were assessed. The House-Brackmann scale was used to display concurrent validity which was established by Spearman's rho correlation.The Cronbach's α score exceeded 0.70. The intra-rater intraclass correlation coefficient (ICC) was nearly perfect for the composite score (0.96-0.99), voluntary movements (0.97-0.99), and synkinesis (0.91-0.98), and important to almost perfect for symmetry at rest (0.79-0.97). In both evaluations, the inter-rater ICC was higher than 0.90 for the composite score (0.92-0.96) and voluntary movements (0.91-0.96) and slightly lower for symmetry at rest (0.66-0.85) and synkinesis (0.72-0.87). A strong negative correlation was found between the H-B scale and SFGS (Spearman's rho coefficient = - 0.92, p 0.001) in both evaluations.The Spanish version of the SFGS is a reliable and valuable instrument for the assessment of facial function in the diagnosis and treatment of patients with FP.

Resumen Introduccion La electrococleografia (ECoG) es un registro de un episodio electrofisiologico, que tiene lugar en la coclea tras un estimulo acustico. La mayoria de los autores consideran que un aumento del cociente SP/AP utilizando clicks, es caracteristico del hidrops. Metodos Presentamos un estudio longitudinal y prospectivo de una poblacion de pacientes con enfermedad de Meniere unilateral definida segun los criterios de la Academia Americana de Otorrinolaringologia y patologia cervicofacial. Tras una correcta anamnesis y exploracion otoneurologica completa, todos los pacientes fueron sometidos a un estudio de la funcion auditiva y vestibular mediante audiometria tonal liminar, pruebas caloricas, rotatorias y una ECoG extratimpanica. Como controles se escogieron 20 sujetos normoacusicos carentes de antecedentes de afeccion vestibular u otologica, ni antecedentes quirurgicos en el oido medio. Resultados De los 100 pacientes incluidos, 62 fueron diagnosticados de enfermedad de Meniere definida, 13 de probable y 25 de enfermedad de Meniere posible. Un 85% de la poblacion con enfermedad de Meniere, cumplian criterios electrofisiologicos de enfermedad de Meniere segun los parametros de la ECoG (SP/AP > 0,5). El porcentaje de ECoG alteradas segun el diagnostico era del 92, 78 y 75% para el Meniere definido, probable y posible respectivamente. Discusion y conclusiones La ECoG es un metodo util para el diagnostico y evaluacion de la enfermedad de Meniere. Aporta informacion fidedigna del progreso de la enfermedad y existe correlacion con su estadio diagnostico.

Intratympanic (IT) dexamethasone provides an alternative for patients with Ménière's disease (MD). A reduction of the endolymphatic hydrops is detected by the EcohG 1 month after the treatment.The use of intratympanic corticoid injections for MD has become popular due to the lack of reported adverse effects, but the mechanism of action is not well established. This study aimed to evaluate the changes in electrocochleography (EcohG) measurements during IT dexamethasone therapy.This study included 53 patients with unilateral MD refractory to medical therapy for at least 1 year. Each patient was treated with a fixed protocol of three consecutive weekly injections of a commercial 4 mg/ml dexamethasone preparation. EcohG measurements were performed 1 month before and 1 month after IT steroid therapy. The SP/AP ratio was measured before and after the IT treatment. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period.Complete vertigo control (class A) was achieved in 22 patients (41.5%) at the 12-month follow-up and 8 patients (15.1%) at the 24-month follow-up. A significant reduction (p0.01) in the SP/AP ratio after the IT steroid treatment was observed.

Introduction Electrocochleography is the registration of an electrophysiological event which takes place in the cochlea after an acoustical stimulus. Most of the authors consider an increased summating potential (SP)/action potential (AP) ratio as characteristic of endolymphatic hydrops. Methods A longitudinal, prospective study of a unilateral Meniere's population diagnosed according to the American Academy of Otolaryngology–Head and Neck Surgery classification was carried out. A complete clinical history and bedside examination were performed, in addition to complete auditory and vestibular testing and an extratympanic electrocochleography. We selected 20 normal hearing subjects with no history of vestibular and otological pathology as a control group. Results Of the 100 patients included in the study, 62 were diagnosed as definite Meniere's disease, and 13 and 25 as probable and possible Meniere's disease, respectively. In the electrocochleography, 85% of all the patients had an SP/AP ratio above 0.5. A sensibility of 92%, 78% and 75% was obtained in the definite, probable and possible Meniere's disease patients, respectively. Discussion and conclusions Electrocochleography is a useful method for diagnosing and evaluating patients with Meniere's disease syndrome. It provides information about the progression of the process and shows a significant correlation with the clinical stage.