Vestibular-Evoked Myogenic Potential Findings in Patients with Unilateral Idiopathic Sudden Sensorineural Hearing Loss

Abstract

We investigated vestibular function in patients with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and vertigo, and assessed the relationship between hearing loss grade and cervical vestibular-evoked myogenic potentials (cVEMPs) and ocular VEMP (oVEMPs) findings. Material and Methods: The study included 31 patients diagnosed with unilateral ISSNHL and vertigo, and 26 healthy individuals (control group) with VEMP. In all participants, pure tone audiometry was used to assess the hearing threshold, and cVEMP and oVEMP tests were used to assess vestibular system function. The P1/N1 latency, P1-N1 interval and amplitude asymmetry ratio (AAR) were measured in the VEMP test. Additionally, the relationship between the VEMP findings and the degree of hearing loss was assessed. Results: We found no significant differences in VEMP parameters (N1 latency, P1-N1 interval, and amplitude) between the affected and control group ears (p>0.05). In contrast, the cVEMP P1 latency and AARs were significantly different between the patient and control groups (p=0.019 and 0.015, respectively). No significant differences were found in VEMP parameters (P1 latency, N1 latency, P1-N1 interval, and amplitude) or AAR in the patients with profound and nonprofound hearing loss in the cVEMP and oVEMP tests (p>0.05). Conclusions: Vestibular otolithic dysfunction can be detected using cVEMP and oVEMP in patients with ISSHL and vertigo. The VEMP amplitude asymmetry and VEMP responses have high diagnostic value in patients with ISSNHL with vestibular symptoms. Abnormal cVEMP responses provide more information than oVEMP responses about vestibular otolithic damage in patients with ISSHL. Although the saccule and utricle were affected in ISSNHL, the extent of saccular and utricular damage did not correspond to the amount of hearing loss.

The effect of the severity of COVID-19 on the sequelae of the audiovestibular system

“…In c-VEMP responses, we found that the n23 latency value in the right ear was the highest in the control group and lower in the patient groups. Furthermore, the latency of p13 for the left ear was highest in the outpatient group and lowest in the inpatient 15 Since the beginning of the COVID-19 pandemic, case reports, reviews, brief clinical reports, and a limited number of clinical studies have been published on audiovestibular symptoms such as vertigo, tinnitus, and hearing loss in COVID-19 positive individuals. Aljasser et al reported that the number of patients suffering from recognizable alterations in auditory symptoms was low and they could not find a statistically significant difference between COVID-19 patients and controls.…”

“…Today, VEMP tests are an essential component of the vestibular measurement battery and maintain a clinical evaluation of frequent vestibular diseases, including Meniere’s disease, vestibular neuritis, and superior canal dehiscence syndrome. 15 …”