ORIGINAL ARTICLE
AIR- AND BONE-CONDUCTION VESTIBULAR EVOKED MYOGENIC POTENTIALS IN CHRONIC SUPPURATIVE OTITIS MEDIA, PRE- AND POST-OPERATIVELY
 
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1
Audio-Vestibular Unit, Department of Otolaryngology, Cairo University, Cairo, Egypt
2
Department of Otolaryngology, Cairo University, Cairo, Egypt
CORRESPONDING AUTHOR
Abeir O. Dabbous   

Abeir O. Dabbous, Audio-Vestibular Unit, Department of Otolaryngology, Cairo University, Cairo, Egypt, e-mail: abeird@yahoo.com; abeirdabbous@kasralainy.edu.eg
Publication date: 2020-04-16
 
J Hear Sci 2014;4(4):21–35
 
KEYWORDS
ABSTRACT
Background:
Vestibular evoked myogenic potentials (VEMPs) are reflex myogenic potentials of the neck muscles elicited by stimulating the vestibular system with a click or tone burst sound stimulus. VEMP responses depend on good energy transfer of sound from the middle ear to the inner ear and are presumed absent in the presence of a conductive hearing loss (CHL) of more than 20 dB air-bone gap (ABG). The aim of this study was to evaluate VEMPs in patients with chronic suppurative otitis media (CSOM) before and after surgery.

Material and Methods:
The study was conducted on 20 patients with CSOM preoperatively and postoperatively and on 20 controls. Their ages ranged from 20 to 50 years. Each subject underwent history taking, otologic examination, basic audiological evaluation, and air- and bone-conducted VEMP testing.

Results:
All perforated ears showed a lost air conduction VEMP response pre-operatively without any post-operative improvement. This can be attributed to the absence of any statistically significant differences between the pre-operative and post-operative ABGs at all tested frequencies. Bone conduction VEMP was preserved in all CSOM cases pre-operatively and post-operatively. There were no statistically significant differences between the air conduction and bone conduction VEMP parameters in the controls except for a significantly smaller P13–N23 amplitude of bone conduction VEMP compared to air conduction VEMP. There was no statistically significant differences between the pre-operative perforated ears of CSOM cases and their controls regarding bone conduction P13, N23 latencies, or P13–N23 amplitude. There was a significantly delayed P13 latency and greater P13–N23 amplitude of bone conduction VEMP post-operatively compared to pre-operatively. But there was no statistically significant difference between pre-operative and post-operative bone conduction N23 VEMP latency or interaural amplitude difference. Bone conduction VEMP results were pre-operatively affected by the ABG and bone conduction, but not post-operatively.

Conclusions:
Air conduction VEMP in patients with CSOM showed a zero-percent response rate pre-operatively that did not change post-operatively, whereas bone conduction VEMP showed a 100% response rate pre- and post-operatively. We therefore recommend using bone rather than air conduction VEMP for assessment of the sacculo-collic reflex in patients with CSOM who complain of balance problems.

 
REFERENCES (23)
1.
Murofushi T, Matsuzaki M, Wu CH. Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle: are these potentials also of vestibular origin? Arch Otolaryngol Head Neck Surg, 1999; 125: 660–4.
 
2.
Wu CH, Young YH, Murofushi T. Tone burst-evoked myogenic potentials in human neck flexor and extensor. Acta Otolaryngol (Stockh), 1999; 119: 741–4.
 
3.
Murofushi T, Halmagyi GM, Yavor RA, Colebatch JG. Absent vestibular evoked myogenic potentials in vestibular neuro-labyrinthitis. An indicator of inferior vestibular nerve involvement? Arch Otolaryngol Head Neck Surg, 1996; 122: 845–8.
 
4.
Murofushi T, Matsuzaki M, Mizuno M. Vestibular evoked potential in patient with acoustic neuromas. Arch Otolarynogol Head Neck Surg, 1998; 124: 509–12.
 
5.
Murofushi T, Shimizu K, Takegoshi H, Cheng PW. Diagnostic value of prolonged latencies in vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg, 2001; 127: 1069–72.
 
6.
Halmagyi GM, Colebatch JG, Curthoys IS. New tests of vestibular function. Baillieres Clin Neurol, 1994; 3: 485–500.
 
7.
Wang M-C, Lee G-S. Vestibular evoked myogenic potentials in middle ear effusion. Acta Otolaryngol, 2007; 127: 700–4.
 
8.
World Health Organization. Chronic Suppurative Otitis Media: Burden of illness and management options. Geneva, Switzerland, 2004.
 
9.
Yang TL, Young YH. Comparison of tone burst and tapping evocation of myogenic potentials in patients with chronic otitis media. Ear Hear, 2003; 24: 191–4.
 
10.
Wang MC, Liu CY, Yu EC, Wu HJ, Lee GS. Vestibular evoked myogenic potentials in chronic otitis media before and after surgery. Acta Otolaryngol, 2009; 129(11): 1206–11.
 
11.
Sheykholeslami K, Murofushi T, Kermany MH, and Kaga K. Bone-conducted evoked myogenic potentials from the sternocleidomastoid muscle. Acta Otolaryngol, 2000; 120(6): 731–4.
 
12.
Miyamoto A, Seo T, Node M, Hashimoto M, Sakagami M. Preliminary study for vestibular-evoked myogenic potential induced by bone-conducted stimuli. Otol Neurotol, 2006; 27: 1110–14.
 
13.
Seo T, Miyamoto A, Saka N, Shimano Nishida T, Hashimoto M, Sakagami M. Vestibular evoked myogenic potential induced by bone-conducted stimuli in patients with conductive hearing loss. Acta Otolaryngol, 2008; 128: 639–43.
 
14.
Soliman SM, Fathalla A, Shehata M. Development of Arabic staggered spondee words (SSW) test. In: Proceedings of 8th Ain Shams Med Congress, 1985; 2: 1220–46.
 
15.
Soliman SM. Speech discrimination audiometry using Arabic phonetically-balanced words. Ain Shams Med J, 1976; 27: 27–30.
 
16.
Lee SK, Cha CI, Jung TS, Park DC, Yeo SG. Age related differences in parameters of vestibular evoked myogenic potentials. Acta Otolaryngol, 2008; 128: 66–72.
 
17.
El-Khousht, MM, Hossni, NA, El-Abd SM, El-Shenawy, AM. Vestibular evoked myogenic potentials (VEMP) in conductive hearing loss. Med J Cairo Univ, 2010; 78(1): 539–41.
 
18.
Lee, JS, Lee SK, Shin IH, Yeo SG, Park MS, Byun JY. Vestibular evoked myogenic potentials according to middle ear condition in chronic otitis media with tympanic membrane perforation. Acta Otolaryngol, 2014; 134(1): 34–40.
 
19.
Paparella MM, Brady DR, Hoel R. Sensori-neural hearing loss in chronic otitis media and mastoiditis. Trans Am Acad Ophthalmol Otolaryngol, 1970; 74: 108–15.
 
20.
Sakagami M, Maeda A, Node M, Sone M, Makino Y. Longterm observation on hearing change in patients with chronic otitis media. Auris Nasus Larynx, 2000; 27: 117–20.
 
21.
Morizono T. Middle ear inflammatory mediators and cochlear function. Otolaryngol Clin North Am, 1991; 24: 835–43.
 
22.
Ho K, Chien C, Tsai S, Chen C, Wang H. Clinical significance of vestibular function with caloric and vestibular evoked myogenic potential testing for patients with simple chronic otitis media. Int Adv Otol, 2012; 8(3): 447–52.
 
23.
Trivelli M, d’Ascanio L, Pappacena M, Greco F, Salvinelli F. Air- and bone-conducted vestibular evoked myogenic potentials (VEMPs) in otosclerosis: recordings before and after stapes surgery. Acta Otorhinolaryngol Ita, 2010; 30: 5–10.