Application of Cervical Vestibular-Evoked Myogenic Potentials in Adults with Moderate to Profound Sensorineural Hearing Loss: A Preliminary Study

Abstract

Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.

Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss—A Retrospective Study

“…For patients who suffer from hearing loss after an episode of SSNHL, cochlear implantation may be the only opportunity, due to the possible ossification of the cochlea-especially after viral infections [20][21][22][23]. As far as diagnostics of moderate to profound sensorineural hearing loss (MPSHL), the use of cVEMPs (cervical vestibular-evoked myogenic potentials) to identify and intervene promptly in cases of vestibular disorders, which could endanger the process of integration of the critical sensory stimuli for correct posture and locomotion [24,25]. Additionally, the evidence for viral involvement in SSNHL, Ménière's disease, and vestibular neuritis is indirect and equivocal [26,27].…”

Association between Chronic Obstructive Pulmonary Disease and Ménière’s Disease: A Nested Case—Control Study Using a National Health Screening Cohort

“…However, due to the health claim code database, laboratory findings, such as pulmonary function tests and vestibular function tests, were not available. The difficulty of diagnosis of Ménière’s disease could have originated from the combined cochleovestibular dysfunction in as high as 71.5% of moderate to profound sensorineural hearing loss patients [ 43 ]. In addition, anatomical variation could trigger Menieriform syndrome [ 44 ].…”

Differential Levels of Endoplasmic Reticulum Stress in Peripheral Blood Mononuclear Cells from Patients with Sudden Sensorineural Hearing Loss

“…SNHL has been associated with ERS in animal studies [ 6 – 8 ] and ERS may serve as an indicator of vascular or nerve damage [ 2 ]. To date, however, there are no reports in the literature about the role of ERS in SSNHL, probably because of the inability to obtain tissue samples from the inner ear of patients at the onset of SSNHL, and the lack of reliable SSNHL animal models.…”

“…It primarily presents as acute hearing loss, tinnitus, and dizziness requiring urgent care by an otorhinolaryngologist [ 1 ]. Some previous data suggested that SSNHL could be idiopathic, or originate from other diseases, such as vascular, infectious, or otologic conditions [ 1 , 2 ]. SSNHL is primarily treated with glucocorticoids (GCs) such as dexamethasone and methylprednisolone.…”

“…Endoplasmic reticulum stress (ERS) is defined as an accumulation of unfolded or misfolded proteins in the endoplasmic reticulum (ER) when cells are exposed to pathophysiological stressors. ERS is associated with various neurological and cardiovascular diseases [ 2 , 3 ]. During the early stages of ERS, cells can adapt to altered environmental conditions by reducing protein synthesis and enhancing protein folding and degradation of misfolded proteins.…”