Sudden Bilateral Hearing Loss After Cervical and Ocular Vestibular Evoked Myogenic Potentials

Mattingly, Carolyn J.; Portnuff, Cory; Hondorp, Brian M.; Cass, Stephen P.

doi:10.1097/mao.0000000000000764

Cited by 29 publications

(30 citation statements)

References 12 publications

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“…Since several frequencies were used for evoking oVEMP, this would indirectly mean replication, if responses were present. Furthermore, unnecessary replication of waveforms would mean exposure of high-intensity sounds to ear for longer duration which is being regarded a concern these days (Krause et al, 2013;Mattingly et al, 2015).…”

Section: Methodsmentioning

confidence: 99%

Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere’s Disease from BPPV

Singh

Barman

2016

J Am Acad Audiol

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Section: Methodsmentioning

confidence: 99%

Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere’s Disease from BPPV

Singh

Barman

2016

J Am Acad Audiol

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“…In adults, changes in cochlear function and an increase in otologic symptoms have been reported post-VEMP. [40][41][42][43] Because children have smaller ear canal volume (ECV) and may require more repetitions of stimuli to see a reliable response compared with adults, they could be at an even greater risk for unsafe sound exposure during traditional VEMP testing. 44 However, modifications to VEMP testing for the pediatric population can improve the reliability, clinical efficiency, and safety of the test procedure.…”

Section: Quantitative Tests Of Vestibular Functionmentioning

confidence: 99%

Quantitative Vestibular Function Testing in the Pediatric Population

Janky

Rodriguez

2018

Semin Hear

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Quantitative tests of vestibular function include the caloric test, cervical and ocular vestibular evoked myogenic potential (VEMP), rotary chair, and head impulse test, either at the bedside or utilizing video head impulse test (vHIT). The purpose of this article is to provide an overview of how to perform these tests in children, including which tests are recommended based on the child's age and any modifications or considerations that can be made. A variety of clinical measures have been recommended as screening measures for vestibular loss, which will be reviewed. Symptom questionnaires designed to assess the functional impact of dizziness and vestibular loss in children will also be discussed. If a child complains of dizziness or if vestibular loss is suspected (either by case history or positive screening measure), vestibular function testing is warranted. For vestibular function testing, children aged 0 to 2 years typically receive rotary chair, cervical VEMP, and vHIT if a remote system is available. For children aged 3 to 7 years, vHIT, cervical VEMP, and ocular VEMP are completed, and for children aged 8+ years, vHIT, caloric testing if vHIT is normal, and cervical and ocular VEMP are completed. For all children, modifications to testing can be made, as needed.

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“…Sudden sensorineural hearing loss in response to VEMP testing has been reported in only one participant (Mattingly et al, 2015). However, in spite of the low incidence of adverse effects following VEMP testing, the use of high-intensity stimuli raises concerns regarding safety, particularly with children, where sound levels may be higher due to smaller ear canal volumes than adults.…”

Section: Introductionmentioning

confidence: 99%

Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children

Thomas¹,

Fitzpatrick²,

McCreery³

et al. 2017

J Am Acad Audiol

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Background Cervical and ocular Vestibular Evoked Myogenic Potentials (VEMPs) have become common clinical vestibular assessments. However, VEMP testing requires high intensity stimuli, raising concerns regarding safety with children, where sound pressure levels may be higher due to their smaller ear canal volumes. Purpose The purpose of this study was to estimate the range of peak-to-peak equivalent sound pressure levels (peSPLs) in child and adult ears in response to high intensity stimuli (i.e., 100 dB normal hearing level (nHL)) commonly used for VEMP testing and make a determination of whether acoustic stimuli levels with VEMP testing are safe for use in children. Research Design Prospective Experimental. Study Sample Ten children (4–6 years) and ten young adults (24 – 35 years) with normal hearing sensitivity and middle ear function participated in the study. Data Collection and Analysis Probe microphone peSPL measurements of clicks and 500 Hz tonebursts (TBs) were recorded in tubes of small, medium, and large diameter, and in a Brüel & Kjær Ear Simulator Type 4157 to assess for linearity of the stimulus at high levels. The different diameter tubes were used to approximate the range of cross-sectional areas in infant, child, and adult ears, respectively. Equivalent ear canal volume and peSPL measurements were then recorded in child and adult ears. Lower intensity levels were used in the participant’s ears to limit exposure to high intensity sound. The peSPL measurements in participant ears were extrapolated using predictions from linear mixed models to determine if equivalent ear canal volume significantly contributed to overall peSPL and to estimate the mean and 95% confidence intervals of peSPLs in child and adult ears when high intensity stimulus levels (100 dB nHL) are used for VEMP testing without exposing subjects to high-intensity stimuli. Results Measurements from the coupler and tubes suggested: 1) each stimuli was linear, 2) there were no distortions or non-linearities at high levels, and 3) peSPL increased with decreased tube diameter. Measurements in participant ears suggested: 1) peSPL was approximately 3 dB larger in child compared to adult ears, and 2) peSPL was larger in response to clicks compared to 500 Hz TBs. The model predicted the following 95% confidence interval for a 100 dB nHL click: 127–136.5 dB peSPL in adult ears and 128.7–138.2 dB peSPL in child ears. The model predicted the following 95% confidence interval for a 100 dB nHL 500 Hz TB stimulus: 122.2 – 128.2 dB peSPL in adult ears and 124.8–130.8 dB peSPL in child ears. Conclusions Our findings suggest that 1) when completing VEMP testing, the stimulus is approximately 3 dB higher in a child’s ear, 2) a 500 Hz TB is recommended over a click as it has lower peSPL compared to the click, and 3) both duration and intensity should be considered when choosing VEMP stimuli. Calculating the total sound energy exposure for your chosen stimuli is recommended as it accounts for both duration and intensity. When using this calc...

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Sudden Bilateral Hearing Loss After Cervical and Ocular Vestibular Evoked Myogenic Potentials

Cited by 29 publications

References 12 publications

Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere’s Disease from BPPV

Utility of the Frequency Tuning Measure of oVEMP in Differentiating Meniere’s Disease from BPPV

Quantitative Vestibular Function Testing in the Pediatric Population

Big Stimulus, Little Ears: Safety in Administering Vestibular-Evoked Myogenic Potentials in Children

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