The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière’s Disease

Abstract

Ménière’s disease (MD) is a condition that has been proposed over 150 years ago, which involves audiological and vestibular manifestations, such as aural fullness, tinnitus, vertigo, and fluctuating hearing thresholds. Over the past few years, many researchers have assessed different techniques to help diagnose this pathology. Vestibular-evoked myogenic potential (VEMP) is an electrophysiological method assessing the saccule (cVEMP) and the utricule (oVEMP). Its clinical utility in the diagnosis of multiple pathologies, such as superior canal dehiscence, has made this tool a common method used in otologic clinics. The main objective of the present review is to determine the current state of knowledge of the VEMP in the identification of MD, such as the type of stimuli, the frequency tuning, and the interaural asymmetry ratio of the cVEMP and the oVEMP. Results show that the type of stimulation, the frequency sensitivity shift and the interaural asymmetry ratio (IAR) could be useful tool to diagnose and describe the evolution of MD. It is, however, important to emphasize that further studies are needed to confirm the utility of VEMP in the identification of MD in its early stage, using either bone-conduction vibration or air-conduction stimulation, which is of clinical importance when it comes to early intervention.

Can Narrow Band Chirp Stimulus Shake the Throne of 500 Hz Tone Burst Stimulus for Cervical Vestibular Myogenic Potentials?

“…Another parameter in the cVEMP test is the IAR. This difference in asymmetry between the ears is especially important in showing the progression of disease [ 22 ]. In this study, there was no difference in asymmetry between the ears in both stimuli.…”

Current Understanding and Clinical Management of Meniere's Disease: A Systematic Review

“…71 -Vestibular evoked myogenic potentials (VEMPs): This is a test that uses cervical or ocular muscles reflexes evoked by a loud noise in the ear or high-frequency vibration, which helps to evaluate the function of the saccule (cVEMP) and utricle (oVEMP). 72,73 Its role for MD diagnosis is so far unestablished (sensitivity: 50%; specificity: 49%). 74 -Video head impulse test: This is an objective measure of the VOR for each semicircular canal.…”

Evidence-based diagnostic use of VEMPs

“…The following section focuses on characteristic VEMP responses in peripheral vestibular disorders that have contributed to a better understanding of the neurophysiology behind VEMPs or that provide additional information as compared to other vestibular tests. Detailed accounts of clinical VEMP applications have been provided by, for example [ 14 , 26 , 46 , 50 , 57 , 62 , 70 , 74 , 81 , 84 ].…”