Is There a Safe Level for Recording Vestibular Evoked Myogenic Potential? Evidence From Cochlear and Hearing Function Tests

Singh, Niraj Kumar; Keloth, Nainitha Kizhake; Sinha, Sachchidanand

doi:10.1097/aud.0000000000000646

Cited by 9 publications

(7 citation statements)

References 43 publications

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“…The participants were seated in a comfortable chair with an upright posture. mVEMP was elicited by tone bursts of 500 Hz (2-0-2 cycle) delivered at 125 dB peSPL in compliance with the safety recommendations by Singh et al 20 Stimuli were presented monaurally at the rate of 5.1 Hz into the ear canal through the etymotic ER3A insert earphones. The surface electromyographic (EMG) activity of masseter muscle was picked-up using the belly tendon configuration with an active electrode placed on the lower third of the masseter muscle, reference electrode over the zygomatic arch (2 cm above the active electrode), and ground over the forehead 5 as seen in ►Fig.…”

Section: Recording Of Mvempmentioning

confidence: 99%

Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

2021

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Background Masseter vestibular evoked myogenic potential (mVEMP) is a recent tool for the assessment of vestibular and trigeminal pathways. Though a few studies have recorded mVEMP using click stimuli, there are no reports of these potentials using the more conventional VEMP eliciting stimuli, the tone bursts. Purpose The aim of the study is to establish normative values and determine the test–retest reliability of tone burst evoked mVEMP. Research Design The research design type is normative study design. Study Sample Forty-four healthy participants without hearing and vestibular deficits in the age range of 18 to 50 years participated in the study. Data Collection and Analysis All participants underwent mVEMP testing using 500 Hz tone-burst stimuli at 125 dB peSPL. Ten participants underwent second mVEMP testing within 1 month of the initial testing to estimate the test–retest reliability. Results Tone burst mVEMP showed robust responses in all participants. There were no significant ear and sex differences on any mVEMP parameter (p > 0.05); however, males had significantly higher EMG normalized peak-to-peak amplitude than females. Intraclass correlation coefficient (ICC) values of tone burst mVEMP showed excellent test–retest reliability (ICC >0.75) for ipsilateral and contralateral p11 latency, ipsilateral EMG normalized p11-n21 peak to peak amplitude, and amplitude asymmetry ratio. Fair and good test–retest reliability (0.4 < ICC > 0.75) was observed for ipsilateral and contralateral n21 latency, contralateral EMG normalized peak-to-peak amplitude, and amplitude asymmetry ratio. Conclusion Tone burst mVEMP is a robust and reliable test for evaluating the functional integrity of the vestibulomasseteric reflex pathway.

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Section: Recording Of Mvempmentioning

confidence: 99%

Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

2021

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“…A recent study evaluating the otoacoustic emissions (OAE) and PTA in young adults undergoing VEMP testing (125 dBpeSPL) showed no significant changes. 6 These studies show that the acoustic stimulation of VEMP can temporarily affect DPOAE levels but not PTA thresholds in young subjects depending on the stimulation sound level, although the effect in the elderly is still unknown and requires investigation. Initial guidelines for VEMP testing recommended a maximum sound pressure of 140 dBpSPL, including attention to L Aeq,8hr 7 ; however, the recommended maximum safety level was reduced to 126 dBpSPL within a few years, 1 which indicates that the actual safety level of the sound pressure is still under investigation.…”

Section: Discussionmentioning

confidence: 92%

“…There were no PTA threshold increases reported (Figure 2), and DPOAE levels decreased but recovered in 24 h. Strömberg et al 5 also reported a DPOAE level decrease and no PTA threshold increase after VEMP sound stimulation (130 dBpeSPL). A recent study evaluating the otoacoustic emissions (OAE) and PTA in young adults undergoing VEMP testing (125 dBpeSPL) showed no significant changes 6 …”

Section: Discussionmentioning

confidence: 97%

Sudden bilateral hearing loss after vestibular‐evoked myogenic potentials

Asakura

Kamogashira

2021

Clinical Case Reports

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“…The resulting stimulus duration and intensity combination falls well within the proposed limit of safety. 22 23…”

Section: Methodsmentioning

confidence: 99%

Simultaneous Multifrequency (SiMFy) Stimulus: A Novel and Reliable Stimulus for Frequency Tuning of Ocular Vestibular-Evoked Myogenic Potentials

Singh¹,

Ravikumar²,

Maruthy³

2022

J Am Acad Audiol

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Background Frequency tuning of ocular vestibular evoked myogenic potential (oVEMP) refers to the frequency of tone burst that produces the largest amplitude oVEMP. There is an ever-growing pool of published studies that found the frequency tuning of oVEMP distinctly different in Ménière's disease than the age-matched controls and benign paroxysmal positional vertigo. However, recording oVEMP in response to many frequencies makes an already lengthy vestibular test battery even more cumbersome and time-consuming. Purpose The aim of this study was to develop a novel time-saving stimulus that produces reliable results. Research Design Prospective study. Study Sample The study included 25 young, healthy adults. Data Collection The tone-bursts of 2000, 1500, 1000, 750, 500, and 250 Hz were generated and sequenced in this order to prepare a stimulus for simultaneous multifrequency (SiMFy) oVEMP. The response parameters of SiMFy and conventional oVEMP methods were compared. Results No significant difference in peak-to-peak amplitude and frequency tuning existed between conventional and SiMFy oVEMP (p > 0.05). SiMFy had better test–retest reliability and was less time-consuming than the conventional oVEMP. Conclusions SiMFy is a time-saving and reliable stimulus for obtaining frequency tuning of oVEMP with no compromise on the outcomes. It can be immediately applied in most commercially available evoked potential systems with a facility for loading an external stimulus.

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Is There a Safe Level for Recording Vestibular Evoked Myogenic Potential? Evidence From Cochlear and Hearing Function Tests

Cited by 9 publications

References 43 publications

Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

Tone Burst Masseter Vestibular Evoked Myogenic Potentials: Normative Values and Test–Retest Reliability

Sudden bilateral hearing loss after vestibular‐evoked myogenic potentials

Simultaneous Multifrequency (SiMFy) Stimulus: A Novel and Reliable Stimulus for Frequency Tuning of Ocular Vestibular-Evoked Myogenic Potentials

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