Indication of the Side of Delayed Endolymphatic Hydrops by Vestibular Evoked Myogenic Potential and Caloric Test

Abstract

Objective: Delayed endolymphatic hydrops (DEH) can be clinically classified into ipsi- and contralateral types. This study aims to investigate the relationship between the results of vestibular evoked myogenic potential (VEMP) and caloric testing and the clinical type of DEH. Methods: The data of 33 patients with DEH who underwent both VEMPs and caloric testing were retrospectively examined. The type of DEH was judged from its clinical and audiological course. Theasymmetry ratios of the VEMPs and canal paresis on the caloric test were measured. Results: The results of VEMP and the caloric testing were consistent with the type of DEH in 61 and 76% of DEH patients, respectively. Combined use of VEMP and caloric testing correctly identified the type of DEH in 82% of patients. Conclusions: The combined use of VEMP and caloric testing can indicate the type of DEH at a reasonably high rate, but inconclusively.

The Use of Vestibular Test Battery to Identify the Stages of Delayed Endolymphatic Hydrops

“…2 These findings correlate with the high rate (70%) of abnormal cVEMPs for DEH patients ( Table 2) and are compatible with those in previous reports. 21,22 However, DEH ears with absent cVEMPs also provoke episodic vertigo, indicating that factors other than saccule prevail. Thus, function of the utricle and semicircular canals warrants further investigation.…”

Dissociation of Caloric and Video Head Impulse Tests in Patients With Delayed Endolymphatic Hydrops

“…Although many vestibular tests have been applied in patients with DEH, including the electronystagmography (15), caloric test (15,16), rotatory chair (15), and vestibular evoked myogenic potentials (VEMPs) (16,17), no study examined vHIT or the relationship between caloric test and vHIT in these patients. Our study aimed to look into the features of these two VOR tests in DEH patients, and to explore their implications in the diagnosis of ELH or hydropic ear disease.…”

Diagnostic value of three-dimensional magnetic resonance imaging of inner ear after intratympanic gadolinium injection, and clinical application of magnetic resonance imaging scoring system in patients with delayed endolymphatic hydrops

“…Egami et al . found that vestibular-evoked myogenic potential testing and glycerol testing combined could enable relatively accurate identification of delayed endolymphatic hydrops 16 . However, the technique of 3D fluid-attenuated inversion recovery MRI after transtympanic gadolinium injection can directly show the state of endolymphatic hydrops, and can identify delayed endolymphatic hydrops more accurately and easily than the method described by Egami et al .…”

“…16 However, the technique of 3D fluid-attenuated inversion recovery MRI after transtympanic gadolinium injection can directly show the state of endolymphatic hydrops, and can identify delayed endolymphatic hydrops more accurately and easily than the method described by Egami et al…”