Air- and Bone-Conduction Vestibular Evoked Myogenic Potentials in Chronic Suppurative Otitis Media, Pre- and Post-Operatively (original) (raw)
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Evaluation of Cervical Vestibular Evoked Myogenic Potentials in Conductive and Mixed Hearing Losses
Zenodo (CERN European Organization for Nuclear Research), 2023
To evaluate the role of Cervical Vestibular Evoked Myogenic Potentials (cVEMP) in the differential diagnosis of middle and inner ear pathologies by analyzing the test results in conductive or mixed hearing loss in patients with intact tympanic membrane. Material and Method: The study included 50 patients (67 ears) with intact tympanic membranes and had air-bone gap in pure tone audiometry test, who applied to otorhinolaryngology department between January 2019 and September 2022. The cVEMP test results of these patients were evaluated and analyzed. Results: The age range of the patients was 18-75, the mean age was 47.55±13.59, half of them were male and half were female. The most common middle ear pathology was otosclerosis (62%), while the most common inner ear pathology was superior semicircular canal dehiscence (10%). In the other patients (28%), pathologies such as tympanosclerosis, chronic mastoiditis, serous otitis media, ossicular chain pathology, otic capsule dehiscence, and middle ear mass were found. While no cVEMP response was obtained in 41 (82%) of the patients, cVEMP response was obtained in 9 (18%) patients. Conclusion: Preoperative cVEMP response, threshold and amplitude values may help in the differential diagnosis of conductive or mixed hearing loss in patients with intact tympanic membrane. Thus, it can be used to determine the patients to be operated on and the surgical approach.
Medical Science Monitor, 2014
The aim of this prospective clinical study was to evaluate the clinical importance of Vestibular-Evoked Myogenic Potentials (VEMPs) in the assessment and differential diagnosis of otosclerosis and otologic diseases characterized by "pseudo-conductive" components. We also investigated the clinical appearance of balance disorders in patients with otosclerosis by correlating VEMP results with the findings of caloric testing and pure tone audiometry(PTA). Material/Methods: Air-conducted(AC) 4-PTA, bone-conducted(BC) 4-PTA, air-bone Gap(ABG), AC, BC tone burst evoked VEMP, and calorics were measured preoperatively in 126 otosclerotic ears. Results: The response rate of the AC-VEMPs and BC-VEMPs was 29.36% and 44.03%, respectively. Statistical differences were found between the means of ABG, AC 4-PTA, and BC 4-PTA in the otosclerotic ears in relation to AC-VEMP elicitability. About one-third of patients presented with disequilibrium. A statistically significant interaction was found between calorics and dizziness in relation to PTA thresholds. No relationship was found between calorics and dizziness with VEMPs responses. Conclusions: AC and BC VEMPs can be elicited in ears with otosclerosis. AC-VEMP is more vulnerable to conductive hearing loss. Evaluation of AC-VEMP thresholds can be added in the diagnostic work-up of otosclerosis in case of doubt, enhancing differential diagnosis in patients with air-bone gaps. Otosclerosis is not a cause of canal paresis or vertigo.
Perioperative Bone-Conducted Ocular Vestibular-Evoked Myogenic Potentials in Otosclerosis Patients
Otology & Neurotology, 2013
Objective: Vestibular symptoms are seen variably in patients with otosclerosis, both in patients with the disease and in patients after treatment with stapes surgery. The goal of this study was to objectify any changes of the bone-conducted (BC) ocular vestibular evoked myogenic potentials (oVEMPs) in patients with otosclerosis before and after stapes surgery. Study Design: Twenty-six healthy subjects and 27 patients with otosclerosis were tested in a tertiary care center, and 11 of the patients were tested preoperatively and postoperatively. The ears of patients were divided in 4 groups: normal ears, otosclerotic ears, ears after primary stapes surgery, and ears after revision surgery. The stimulus used in oVEMP testing was a BC stimulus delivered by a mini-shaker at stimulus frequencies of 250 and 500
Frontiers in Neurology
ObjectiveThis study investigates the association between vestibular function and prognosis in patients with unilateral idiopathic sudden sensorineural hearing loss (UISSNHL).DesignA retrospective analysis of 64 patients with UISSNHL was performed. Pure tone audiometry and vestibular function tests for otoliths and semicircular canals were performed to assess the influence of vestibular functional status on the outcome of patients with UISSNHL.ResultsPatients with abnormal cervical vestibular evoked myogenic potential (cVEMP) or ocular vestibular evoked myogenic potential (oVEMP) responded less favorably to treatment. In the ineffective group, cVEMP was normal in four patients (6.3%) and oVEMPs in three (4.7%). Meanwhile, cVEMP was abnormal in 32 patients (50.0%) and oVEMP in 33 (51.6%). Better hearing recovery occurred in those with normal cVEMP (33.76 ± 15.07 dB HL improvement) or oVEMP (32.55 ± 19.56 dB HL improvement), but this was not the case in those with normal caloric tests....
Vestibular evoked myogenic potential: its use in Sudden Sensorineural Hearing Loss
The International Tinnitus Journal, 2014
Sudden sensorineural hearing loss (SHL) has uncertain origin and evolution. Vestibular evoked myogenic potential (VEMP) estimates of the vestibular pathway that can not be analyzed by the other entrance examinations, which can be helpful in diagnosing the extent of hearing damage in these patients. Objectives: To investigate the clinical applicability of VEMP in patients with SHL. Methods: This is a systematic review. Searches were conducted in the databases PubMed/Medline, SciELO and LILACS. Data were tabulated. Results: We found 45 articles, 15 of these made up the study by fitting either the inclusion factors. The objective of 60% of the studies was to determine whether the VEMP can be used as predictive hearing recovery Conclusion: VEMP may be useful as hearing recovery predictor in patients with sudden sensorineural hearing loss, justifying the implementation of such examination in this population. LITERATURE REVIEW
International Journal of Neuroscience, 2019
Purpose: This study aimed to assess the clinical value of ocular vestibular evoked myogenic potential (oVEMP) and cervical vestibular evoked myogenic potential (cVEMP) for monitoring the rehabilitation of vestibular function in patients treated for peripheral vertigo. Materials and methods: Fifteen patients who had been diagnosed with peripheral vertigo and showed no VEMP response on the affected side but exhibited symptom alleviation and VEMP responses after therapies were retrospectively enrolled. We analyzed the restoration and parameters of their VEMP response. Results: After treatment, six patients with sudden sensorineural hearing loss showed VEMP recovery, including two with both oVEMP and cVEMP recovery, three with oVEMP recovery only, and one with cVEMP recovery only. Two patients with Meniere's disease (MD) showed cVEMP recovery, while the other three MD patients showed oVEMP recovery. Three patients with herpes zoster oticus exhibited cVEMP recovery. One patient with vestibular neuritis exhibited cVEMP recovery. Among the patients with cVEMP and/or oVEMP restoration, most patients presented normal VEMP parameters; however, some patients showed abnormal VEMP parameters after treatment. Conclusion: Combined oVEMP and cVEMP are objective tools for assessing vestibular otolithic end organ function during dynamic functional recovery from vestibular diseases.
Journal of hearing science, 2013
Background: Vestibular evoked myogenic potential (VEMP) is a test to assess the functioning of otolith organs of the inner ear. Cervical VEMPs (cVEMPs) assess the saccule and the inferior vestibular nerve, whereas ocular VEMPs (oVEMPs) assess the utricle and superior vestibular nerve. In individuals with sensorineural hearing loss, disturbances of cochlear function could accompany vestibular impairment since both these parts of the inner ear are anatomically related. The aim of the present study was to find out the prevalence of cVEMPs and oVEMPs in individuals with congenital severe to profound sensorineural hearing loss. Material and methods: There were 46 participants in the present study: 23 with normal hearing and 23 with bilateral severe to profound hearing loss, and cVEMPs and oVEMPs were recorded from all of them. Results: cVEMPs were present in 100% of subjects, both in the control and experimental groups; oVEMPs were present in 100% of the control and 66% of the experimental group. In hearing impaired individuals no correlation was found between cVEMPs and oVEMPs, although a Mann-Whitney test revealed that the amplitude of cVEMPs and oVEMPs were significantly smaller in the hearing impaired group compared to normals. Conclusions: The results indicate impairment of both utricular and saccular function in individuals with severe to profound hearing loss. Also oVEMPs were absent in more individuals compared to cVEMPs, which suggests that utricular function is more linked with the cochlea compared to that of the saccule.
Acta Oto-Laryngologica, 2013
Conclusion: Patients with vestibular neuritis (VN) with complete canal paresis (CP) showed a higher rate of abnormal ocular vestibular evoked myogenic potential (oVEMP) than those with partial CP. From these results, it is speculated that the superior vestibular nerve function mainly affects oVEMP. Significant correlation was found between the grades of the hearing outcome and oVEMP in sudden sensorineural hearing loss (SSHL). Objective: We attempted to correlate the results of oVEMP with the results of cervical VEMP (cVEMP), results of subjective visual vertical (SVV), and clinical course in patients with various vestibular disorders. Methods: Twenty-two patients with VN, 65 with SSHL, and 22 with Meniere's disease (MD), were enrolled in this study. We compared the results of oVEMP with those of cVEMP, SVV, and the caloric test. Furthermore, the oVEMP results were compared with the initial hearing threshold, presence of vertigo, and hearing recovery in the patients with SSHL. Results: The patients with VN with complete CP showed a higher rate of abnormal oVEMP than those with partial CP. In the patients with SSHL, the hearing recovery rate was lower in the patients with abnormal oVEMP than in those with normal oVEMP.
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Chronic Otitis Media is a permanent abnormality of the pars tensa or flaccida, most likely a result of earlier acute otitis media, negative middle ear pressure or otitis media with effusion. METHODS In our study, we evaluated the hearing status by means of a Pure Tone Audiometry in patients with inactive mucosal chronic otitis media undergoing myringoplasty with a temporalis fascia underlay procedure. RESULTS At the end of the study, the mean improvement in the air bone gap was found to be 7 dB (36.16%) and the mean improvement in the air conduction threshold was found to be 10 dB (25.23%). It was noted that there is a significant hearing improvement. CONCLUSIONS A diseased ear which is diagnosed early and operated early produces better results than a long-standing diseased ear. Also, a long-standing disease produces more hearing loss because of reasons like bone erosion and mucosal change.