kindly provide the VNG interpreattion
Reading File
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Reading File
I have all the data needed. Note: the title says "VNG" but the actual test is an ECochG (Electrocochleography) performed on the SmartEP system - this is an electrophysiological test, not a VNG (videonystagmography). Let me provide the interpretation.
ECochG (Electrocochleography) Interpretation - Suraj Mehra
Note: The attached report is an ECochG (Electrocochleography) test, not a VNG. ECochG measures the summating potential (SP) and action potential (AP) from the cochlea/auditory nerve and is used primarily to assess endolymphatic hydrops (Meniere's disease).
Patient Details
| Field | Value |
|---|---|
| Patient | Suraj Mehra |
| Test Date | 18 June 2026 |
| System | SmartEP 5.54.10 |
| Stimulus | Click, 88 dB nHL, Alternating polarity |
| Rate | 7.1/s |
| Sweeps | 1024 |
Raw Measurements
| Parameter | Right Ear | Left Ear | Normal Reference |
|---|---|---|---|
| SP Latency | 1.30 ms | 1.55 ms | ~1.0-1.5 ms |
| SP Amplitude | 0.03 uV | 0.03 uV | - |
| AP Latency | 2.23 ms | 2.15 ms | ~2.0-2.5 ms |
| AP Amplitude | 0.12 uV | 0.08 uV | - |
| SP-AP Interval | 0.93 ms | 0.60 ms | - |
| SP/AP Amplitude Ratio (AR) | 0.27 | 0.33 | < 0.35-0.40 |
Area Measurements (from waveform tracings)
| Right | Left | |
|---|---|---|
| SP Area | 0.14 uVus | 0.21 uVus |
| AP Area | 0.14 uVus | 0.33 uVus |
| SP/AP Area Ratio | 2.31 | 1.46 |
The area ratios shown in the report header (AP:SP area ratio of 2.31 R and 1.46 L) reflect the ratio of AP area to SP area, which is the inverse of the diagnostic SP/AP ratio. When inverted for diagnostic purposes (SP area / AP area): Right = 0.061, Left = 0.144 - both well within normal limits.
Interpretation
Both ears: Within normal limits for endolymphatic hydrops criteria
Right Ear:
- SP/AP amplitude ratio = 0.27 - Normal (cutoff typically >0.35-0.40)
- SP and AP are well-defined with clear morphology
- SP-AP interval of 0.93 ms is within acceptable range
Left Ear:
- SP/AP amplitude ratio = 0.33 - Normal, though slightly higher than the right ear
- This is still below the commonly used threshold of 0.35-0.40
- SP-AP interval of 0.60 ms is within normal limits
Technical Quality:
- Right ear: SNR 1.84 (borderline; SNR >2.0 is ideal, but >1.5 is generally acceptable at 88 dB)
- Left ear: SNR 0.28 - Poor SNR on the left ear. This is well below the acceptable threshold of >2.0. The left ear waveform should be interpreted with caution, as the low signal-to-noise ratio means the peaks may not be reliable
- Residual noise (RN) is higher on the left (0.477 uV) vs right (0.196 uV), consistent with the poor SNR
Clinical Summary
| Ear | SP/AP Ratio | Endolymphatic Hydrops? |
|---|---|---|
| Right | 0.27 | Not suggested |
| Left | 0.33 | Not suggested (but SNR is poor - reliability limited) |
Overall: No electrodiagnostic evidence of endolymphatic hydrops in either ear based on SP/AP amplitude ratios. However, the left ear recording has a very poor SNR (0.28), which significantly limits confidence in the left ear results. Repeat testing of the left ear under better conditions (quieter environment, better electrode contact, or more sweeps) is recommended before definitively ruling out left-sided pathology.
Clinical Considerations
- ECochG is most commonly ordered when Meniere's disease or endolymphatic hydrops is clinically suspected
- A raised SP/AP ratio (>0.35-0.40 depending on lab norms) or a large, broadened SP suggests hydrops
- Normal ECochG does not entirely exclude Meniere's disease, as the test has a sensitivity of approximately 60-70%
- Correlation with clinical history (episodic vertigo, fluctuating SNHL, aural fullness, tinnitus) and audiometric findings is essential
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