Pilot study on the functional evaluation of vestibular otolith-organ pathway in the stage of patients with Meniere disease / 中华耳鼻咽喉头颈外科杂志

Objective@#To observe the features of air-conducted sound elicited ocular vestibular-evoked myogenic potential(ACS-oVEMP) and cervical vestibular-evoked myogenic potential(ACS-cVEMP) in patients with Meniere disease (MD). To analyze the relationship between air-conducted sound elicited vestibular-evoked myogenic potentials (ACS-VEMP) responses and clinical stages of disease, as well as its clinical application of cervical and ocular vestibular evoked myogenic potentials in MD.@*Method@#Fifty six patients with MD and 50 normal subjects (100 ears) were recruited for conventional cVEMP and oVEMP examinations. Grades of vestibular function were also collected for patients with MD. The relationship between VEMPs abnormity, grades of vestibular function and clinical stages of MD were analyzed.@*Results@#The abnormal rates of cVEMP and oVEMP in MD patients were 57.1% (32/56) and 64.3% (36/56), which were significantly higher than those in normal subjects respectively (χ2=22.286, P=0.000; χ2=15.217, P=0.000). The abnormal rates of cVEMP and oVEMP in MD patients of stage Ⅰ to stage Ⅳ were 20.0% (1/5) and 40.0% (2/5), 50.0% (9/18) and 50.0% (9/18), 59.3% (16/27) and 70.4% (19/27), and 100.0% (6/6) and 100.0% (6/6) respectively. There was a significant difference in cVEMP abnormity between four stages of MD patients (P=0.046). Significant correlation was found between clinical stages and the grades of vestibular dysfunction (rs=0.417, P=0.001).@*Conclusions@#Dysfunction of vestibular otolithic organs and their input pathways in patients with MD can be detected by cVEMP and oVEMP tests. The abnormal rates of VEMP could show an gradually increasing trend with the development of MD stages. And the extent of vestibular lesions could be detected by cVEMP and oVEMP tests, which may provide a reference for clinical staging of MD.

The significance of vestibular function assessment in sudden deafness / 临床耳鼻咽喉头颈外科杂志

Hearing loss caused by cochlear damage is the main symptom of sudden deafness (SD). Some patients also suffer from vestibular symptoms. In recent years, more attention has been paid to the vestibular dysfunction in patients with SD. The lesions could involve the whole inner ear in SD patients with and without vertigo. Comprehensive evaluation of vestibular function may help us understand the extent of lesions in sudden deafness and analyze the pathogenesis of disease. A less involvement of inner ear lesion may indicate a better hearing recovery.

Effects of aging on air-conducted sound elicited ocular vestibular- evoked myogenic potential and cervical vestibular-evoked myogenic potential / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To identify the aging effects on air-conducted sound (ACS) elicited ocular vestibular-evoked myogenic potential (oVEMP) and cervical vestibular-evoked myogenic potential (cVEMP) in normal Chinese population.</p><p><b>METHODS</b>Nighty-seven normal subjects (194 ears) were recruited for conventional ACS-oVEMP and ACS-cVEMP examinations. The candidates'age were 4-83 years old (Ave. ± SD, 45.7 ± 19.3), 41 male and 56 female, divided into 5 groups according to age. 500 Hz short tone burst was employed for examinations. Thresholds were identified and the parameters of the responses to 100dB nHL were calculated and compared among groups. SPSS 13.0 software was used to analyze the date.</p><p><b>RESULTS</b>As the age growing, the response rate for oVEMP decreased. It was recorded 100% in both ≤ 10-year-old and 11-30-year-old groups, 84.00% in the 31-50-year-old group, 48.15% in the 51-70-year-old group and 15.00% in the > 70-year-old group; while that for cVEMP were 100% in both ≤ 10-year-old group and 11-30-year-old group, 82.00% in the 31-50-year-old group, 77.78% in the 51-70-year-old group and 45.00% in the > 70-year-old group. The thresholds elevated and the amplitudes decreased in both examinations with the age growing. However, latencies and latency-intervals of both oVEMP and cVEMP examinations displayed minor difference among groups except that nI latency of oVEMP prolonged with age growing.</p><p><b>CONCLUSIONS</b>With the age growing, the otolithic end organ input pathways degenerate in normal subjects, as shown that ACS elicited oVEMP and cVEMP responsed less with higher threshold and smaller amplitude. The extremely low response rates of both VEMPs in the > 70-year-old group in this study indicates that VEMPs can only provide limited diagnostic information among very old people in clinical practice.</p>