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Electrocochleography (ECOCHG): A Specialized Test to Detect Inner Ear Disorders -By Acoustik Hearing

Do you experience episodes of dizziness, ringing in the ears (tinnitus), ear fullness, or fluctuating hearing loss? These symptoms may indicate an inner ear disorder that routine hearing tests cannot fully identify. Electrocochleography (ECOCHG) is an advanced, painless diagnostic test that helps audiologists and ENT specialists evaluate how the inner ear (cochlea) and hearing nerve respond to sound.

What is Electrocochleography (ECOCHG)?

Electrocochleography, commonly known as ECOCHG, is an objective hearing test that records the tiny electrical signals produced by the cochlea and the auditory nerve when sound enters the ear. Unlike routine hearing tests that rely on your responses, ECOCHG measures these natural electrical responses directly, making it highly reliable even when symptoms are unclear.It is most commonly used to help diagnose Ménière's disease, Endolymphatic Hydrops, and other disorders affecting the inner ear.

How Does ECOCHG Work?

When sound enters your ear, it travels through the ear canal, vibrates the eardrum, and is transmitted by the middle ear bones to the cochlea. Inside the cochlea are thousands of delicate hair cells that convert sound vibrations into electrical signals. These signals travel through the hearing nerve to the brain, allowing you to hear.

ECOCHG records three important responses:

Cochlear Microphonic (CM): Reflects the function of the outer hair cells.
Summating Potential (SP): Represents the electrical activity generated by the cochlea during sound stimulation.
Action Potential (AP): Represents the synchronized response of the auditory nerve.

The relationship between the SP and AP, known as the SP/AP ratio, provides valuable information about inner ear health.

When is an ECOCHG Test Recommended?

Your ENT specialist or audiologist may recommend ECOCHG if you experience:

Recurrent episodes of vertigo
Ringing or buzzing in the ears (tinnitus)
Feeling of fullness or pressure in one or both ears
Fluctuating hearing loss
Sudden unexplained hearing loss
Suspected Ménière's disease
Balance disorders associated with hearing symptoms

How is the Test Performed?

The test is simple, safe, and usually takes 30–60 minutes.

A small recording electrode is placed either in the ear canal or close to the eardrum, while earphones deliver clicking sounds or tone bursts. You simply relax and remain still while the equipment records your ear's electrical responses. Since ECOCHG measures natural responses, your active participation is minimal.

Understanding the Results

The most important measurement is the SP/AP ratio.

Normal Result: Indicates that the cochlea and hearing nerve are functioning within expected limits.
Increased SP/AP Ratio: May suggest excess inner ear fluid (Endolymphatic Hydrops), commonly associated with Ménière's disease.
Abnormal Waveforms: Can indicate cochlear dysfunction or other inner ear abnormalities. However, ECOCHG results are always interpreted alongside your symptoms, hearing tests, and clinical examination.

Only a qualified audiologist or ENT specialist should interpret the findings.

Why is ECOCHG Important?

Many patients experience dizziness or hearing changes for months before receiving a correct diagnosis. Routine hearing tests alone may not detect certain inner ear disorders. ECOCHG provides additional information that helps doctors identify the underlying problem early, allowing timely treatment and better long-term management.

Advantages of ECOCHG

Objective and highly reliable
Non-invasive (when using ear canal electrodes)
Helps diagnose Ménière's disease and inner ear disorders
Supports accurate treatment planning
Safe for both adults and children
Complements other hearing and balance tests

Final Thoughts

Electrocochleography is an important diagnostic tool that provides valuable insight into the health of your inner ear. If you have persistent dizziness, tinnitus, fluctuating hearing, or a sensation of ear fullness, an ECOCHG evaluation may help identify the cause and guide the most appropriate treatment. Early diagnosis can improve symptom management and protect your hearing.

Don't ignore persistent ear and balance symptoms—early evaluation can make a significant difference in preserving your hearing and quality of life.ECOCHG needs specialized electrophysiological equipment and a quiet, shielded environment, so it's performed at our clinic. Acoustik Hearing and Speech Clinic brings pure tone audiometry and hearing aid trials to your home across @Mumbai, @Navi Mumbai, and @Thane — no travel, no waiting rooms.

Book your pure tone audiometry and hearing aid trial at home, or schedule your ECOCHG test at our clinic.

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