Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis

Abstract

Conclusion:Saccular dysfunction is a major cause of balance problems in patients with otosclerosis. Vestibular-evoked myogenic potential in response to bone-conducted sound (BC-VEMP) testing is useful for diagnosis of these patients.Objectives:The purpose of this study was to elucidate the origin of balance problems in patients with otosclerosis using BC-VEMP.Methods:Subjects comprised 25 patients with unoperated otosclerosis (9 men and 16 women). They were divided into two groups depending on type of balance problems. Results of cochleo-vestibular functions including pure-tone audiometry, caloric testing, and BC-VEMP testing were compared between the two groups.Results:Ten patients had complained of dizziness and/or vertigo (disequilibrium group), and the other 15 patients had not (Non-disequilibrium group). Nine patients showed abnormal results on BC-VEMP testing in the disequilibrium group, while one patient had abnormal results in the non-disequilibrium group (p < 0.001).

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

“…A 2012 study by Saka et al [33] found that balance problems in otosclerosis were associated with abnormal results for BC-VEMP. Conversely, the present analysis of 74 patients with otosclerosis, relying on the assessment of a higher clinical sample than other prospective studies, could not support this theory based on VEMP only.…”

Aplicações dos potenciais evocados miogênicos vestibulares: revisão sistemática de literatura

“…Regarding the design, eight (29%) studies were descriptive (5)(6)(16)(17)(18)28,(30)(31) ,19 (68%) were comparative cross-secti onal (7)(8)(9)(10)(12)(13)(14)(15)(19)(20)(21)29,(32)(33)(34)(35)(36)(37)(38) , and one (3%) was longitudinal cohort (39) .…”

“…Concerning the type of applied stimulation, the number (%) of studies using the sound or the electric stimulation were: 19 (68%), auditory -rarefaction tone burst (6)(7)9,12,(14)(15)(16)(17)(18)21,(28)(29)(30)(31)33,(35)(36)(38)(39) ; three (11%), auditory -rarefaction tone burst and click (8,13,32) ; two (7%), auditory -click (10,37) ; two (7%), galvanic (20,34) ; one (3.5%), auditory -click and galvanic (5) ; one (3.5%), auditory -rarefaction tone burst and galvanic (19) . The electric current intensity of galvanic stimulation ranged from 1 to 5 mA (5,19,20,34) .…”

“…Regarding the frequency of auditory stimulation, 500 Hz was predominant -used in 21 (81%) studies (6)(7)(8)10,(12)(13)(14)(15)(16)(18)(19)(28)(29)(31)(32)(33)(35)(36)(37)(38)(39) , followed by 1000 Hz -applied in two (7%) investigations (17,21) , 600 Hz -used in one (4%) survey (5) , 250 Hz -utilized in one (4%) study (30) , and one research used various frequencies (9) .…”

Perioperative Bone-Conducted Ocular Vestibular-Evoked Myogenic Potentials in Otosclerosis Patients

“…It has already been demonstrated that the elicitability of AC cVEMPs is reduced in otosclerotic patients, most likely because of respectively conductive hearing loss and inner ear impairment (22,23) and that this might correlate with the progression of otosclerosis (22). Also, BC cVEMPs show a lower response rate in otosclerosis (22,24), and a higher frequency of abnormal BC cVEMPs is observed in otosclerotic patients with dizziness than in patients without symptoms (25). When cVEMPs were compared before and after stapes surgery in otosclerosis patients, Trivelli et al (23) found no difference in response rate in both AC and BC cVEMPs, and Singbartl et al (24) show reappearance of the BC cVEMP in 3 of 23 patients after stapes surgery.…”