Otolithic functions in patients with residual dizziness after successful repositioning manoeuvres for unilateral posterior canal BPPV.

OBJECTIVE: To evaluate otolithic functions in patients with residual dizziness after successful canalith repositioning procedures (CRPs) for unilateral posterior canal benign paroxysmal positional vertigo (BPPV), and to investigate possible risk factors. METHODS: This case-control observational study included healthy controls and patients with residual dizziness after improvement following CRP for BPPV. All participants were subjected to full history taking, otoscopy, audiological basic evaluation, Dix-Hallpike test to search for posterior canal BPPV, residual dizziness screening, and vestibular evoked myogenic potential (VEMP) testing. Between-group differences were assessed and possible factors associated with residual dizziness were identified by univariate analysis. RESULTS: A total of 50 patients with residual dizziness (mean age, 56.53 ± 7.46 years [29 female: 21 male]) and 50 healthy controls (mean age, 58.13 ± 7.57 years [20 female: 30 male]) were included. A significant difference in VEMP latencies was found between the patient and control group (delayed in the patient group), with no significant between-group difference in amplitude in both ears. Aging, female sex, long duration of BPPV, number of CRPs, cervical VEMP and ocular VEMP abnormalities, and winter onset, were significantly associated with the risk of residual dizziness. CONCLUSIONS: Residual dizziness is a frequent sequel of BPPV that may relate to otolithic dysfunction. VEMP changes were revealed in the form of delayed latencies.

Diagnostic value of vestibular evoked myogenic potentials in benign paroxysmal positional vertigo.

OBJECTIVES: Vestibular evoked myogenic potentials (VEMPs) are useful for studying the disturbances along nerve pathways implicated in the transmission of neurological information from otolithic organs related to vestibular function. This study aims to determine the differences in VEMPs in patients affected with benign paroxysmal positional vertigo (BPPV). METHODS: We recruited 36 patients, 9 diagnosed with recurrent BPPV (rBPPV), 9 with only one episode of vertigo (iBPPV), and 18 as a control group. We performed cervical and ocular VEMPs (cVEMPs and oVEMPs). RESULTS: We observed differences in asymmetry ratio, which was 41.82% in cVEMPs in iBPPV and 68.27% in oVEMPs in rBPPV, while no asymmetry was found in control cases. Also, there was a lack of both VEMP responses in 22.2% of cases and an absence of cVEMP in 11.1% in iBPPV; in rBPPV, 11.1 % presented no responses in cVEMPs or oVEMPs, 22.2% showed no oVEMP, and 11.1% showed no cVEMP. These values were normal in the control group. CONCLUSION: The value of VEMPs in BPPV demonstrates the implication of vestibular damage, mainly utricle damage. For better sensitivity in detecting otolith abnormalities, we should perform oVEMPs and cVEMPs in recurrent BPPV and early stages of BPPV.

Clinical and Prognostic Implications of Cervical and Ocular Vestibular Evoked Myogenic Potentials (cVEMP and oVEMP) in Benign Paroxysmal Positional Vertigo (BPPV): A Prospective Study.

OBJECTIVE: Several studies have investigated the efficacy of VEMP (vestibular evoked myogenic potential) in patients with vestibular disorders and BPPV (benign paroxysmal positional vertigo). However, previous data were inconclusive. The aim of this study was to investigate the difference in latency, amplitude P1-N1, asymmetry ratio (AR), and cervical/ocular-VEMP values between BPPV patients and healthy controls. METHODS: 125 healthy subjects and 42 BPPV patients were prospectively enrolled in the study. In both groups, c/oVEMP tests with 500 Hz tone-burst stimuli were performed. Latencies P1, N1 peaks, and corrected amplitudes (CA) were measured, and AR was calculated. RESULTS: in the BPPV group, 14.29% of patients lacked oVEMPs that recovered after therapy. N1 latencies were significantly elongated, and 50% of patients had pathological AR; this value normalized at follow-up sessions. In addition, there was a reduction in CA in the pathologic ear compared to healthy ears (p = 0.04) and compared to healthy controls (p = 0.01). For cVEMP, a significant reduction in latency-P1 was observed in BPPV patients compared to controls; no significant differences were observed for P1, N1, and CA values between the two ears. The cVEMPs were absent in 14.29% of BPPV patients (AR > 35) that recovered after therapy. CONCLUSION: We identified several abnormal c/oVemp values in BPPV patients compared with healthy controls, with most changes in values occurring in oVEMPs, suggesting that utricular dysfunction may be more common than saccular. In addition, patients with oVEMP alteration showed later clinical recovery, suggesting a possible prognostic role of the test.

Optimum Response of Air-conduction Induced Ocular Vestibular Evoked Myogenic Potential in Drivers.

Context: During driving, the plane of movement in drivers is horizontal. Hence, utricles and vestibulo-ocular reflex (VOR) pathway are over stimulated. The ocular vestibular evoked myogenic potential (oVEMP) is utilized to evaluate the function of utricle and VOR pathway. Aim: This study aimed to assess the function of utricle and VOR using oVEMP among the drivers and compare it with non-professional drivers. Study Design: Comparative cross-sectional study. Methods: A total of 30 non-professional drivers and 30 professional drivers between ages of 18 and 45 years were evaluated in this study. Drivers with minimum of 5 years driving experience and minimum 3 h of driving per day were included. The oVEMPs were recorded for all the participants using alternating polarity 500 Hz tone bursts stimuli. Statistical Analysis: To calculate mean and standard deviation for all the groups, descriptive statistics was used and for group comparisons Independent t-test, Analysis of Variance, and Mann-Whitney U test were used. Results: The oVEMP of professional drivers exhibited significant delay in peak latency of N1 and P1 than those of non-professional drivers. Significant delay in P1 latency and reduced peak amplitudes were observed in professional drivers with greater than 10 years of experience on comparison with drivers less than 10 years of experience. Conclusions: Current study opens a new research in understanding the effect of over-stimulation of vestibular system in drivers. Driving for longer period may have effect on latency and amplitude parameters of oVEMP.

Skull Vibration-Induced Nystagmus and High Frequency Ocular Vestibular-Evoked Myogenic Potentials in Superior Canal Dehiscence.

BACKGROUND: Although diagnostic criteria have been established for superior canal dehiscence syndrome, cases in which the diagnosis is not easy are frequent. On those occasions, some tests such as vibration-induced nystagmus or vestibular-evoked myogenic potentials can offer invaluable help due to their high sensitivity and specificity. METHODS: We studied 30 patients showing superior canal dehiscence or "near-dehiscence" in a CT scan. Skull vibration-induced nystagmus and high frequency ocular vestibular-evoked myogenic potentials are performed in each patient. The aim of the study is to determine how useful both tests are for detection of superior canal dehiscence or near-dehiscence. RESULTS: Of the 60 temporal bones studied, no dehiscence was the result in 22, near-dehiscence in 17 and a definite finding in 21. In 10/30 patients, there was no SVIN (Skull vibration induced nystagmus) during otoneurological testing, while in 6/30, induced nystagmus was mainly horizontal, and in 14/30 there was vertical up-beating. All patients had a positive oVEMP (Ocular vestibular evoked myiogenic potentials) at 0.5 kHz in both ears and the HFoVEMP (High frequency ocular vestibular evoked myiogenic potentials) response was positive in 25/60 (41.6%) of the ears studied and in 19/30 of the patients evaluated (in 6 it was positive in both ears). Up-beat SVIN will point to a SCD (Superior Canal Dehiscence) mainly when HFoVEMP are present, and when this is negative there is a high probability that it is not a SCD. CONCLUSIONS: When SVIN and HFoVEMP results are added (or combined), they not only improve the possibilities of detecting SCD, but also the affected side.

Effects of primary Sjögren's syndrome on hearing and vestibular systems.

OBJECTIVE: This study aimed to evaluate primary Sjögren's syndrome patients in terms of hearing and vestibular functions. METHODS: The patient group consisted of 35 individuals diagnosed with primary Sjögren's syndrome and a control group of 35 healthy individuals similar in terms of age and gender. RESULTS: The rate of hearing loss in the patient group was significantly higher than in the control group (p = 0.021). The N1 latency value for the ocular vestibular-evoked myogenic potentials test was significantly longer in the patient group than in the control group (p = 0.037). Additionally, the posterior semicircular canal and lateral semicircular canal vestibulo-ocular reflex gain values were significantly lower than in the control group (p = 0.022 and p < 0.001, respectively). CONCLUSION: These results indicate subclinical vestibular involvement and hearing loss in primary Sjögren's syndrome patients. Vestibular-evoked myogenic potentials and video head impulse tests can be used to detect vestibular involvement in primary Sjögren's syndrome patients.

Asymptomatic superior semicircular canal dehiscence.

OBJECTIVE: To describe a case of asymptomatic superior semicircular canal dehiscence. METHOD: Clinical case report. RESULTS: A 50-year-old man presenting with right-sided Ménière´s disease also showed an enhanced response on vestibular evoked myogenic potential testing for the left ear. Unilateral left-sided superior semicircular canal bone dehiscence was clearly visualised on a subsequent temporal bone computed tomography scan. These findings were consistent with superior canal dehiscence syndrome. However, the patient did not complain of any specific superior canal dehiscence syndrome symptoms. Given that vestibular evoked myogenic potential testing may detect asymptomatic forms of superior canal dehiscence, as noted in this case, such testing seems to exhibit reduced specificity for superior canal dehiscence syndrome. CONCLUSION: An enhanced response on vestibular evoked myogenic potential testing in isolation appears to be a weaker indicator of superior canal dehiscence syndrome, and rather a marker of superior semicircular canal dehiscence.

Independent Measures of Utricular Function: Ocular Vestibular Evoked Myogenic Potentials Do Not Correlate With Subjective Visual Vertical or Fundus Photographic Binocular Cyclorotation.

Ocular vestibular evoked myogenic potentials (oVEMPs), subjective visual vertical (SVV), and fundus photographically measured binocular cyclorotation (BCR) are diagnostic tests to assess utricular function in patients with vertigo or dizziness. In 138 patients with chronic vertigo or dizziness, we asked whether the asymmetry ratio of oVEMP (normal, right side pathological, left side pathological) could predict the SVV deviation (normal, rightward deviation, leftward deviation) or BCR (normal, cyclorotation to the right, cyclorotation to the left). There was no correlation between oVEMP and SVV and between oVEMP and BCR, while SVV and BCR correlated highly. Although both oVEMP and SVV measure aspects of utricular function, our findings demonstrate that oVEMP and SVV are not redundant and may reflect different utricular pathologies. The role of fundus photographic BCR may be relegated to only confirm unclear SVV results in vestibular diagnostic workup.

Differences in bone conduction ocular vestibular evoked myogenic potentials to 500 Hz narrow band chirp stimulus and 500 Hz tone burst.

OBJECTIVE: This study aims to investigate the differences of N1 latency, P1 latency and N1P1 amplitude in response to bone conducted 500 Hz tone burst and narrowband CE chirp stimulus in ocular vestibular evoked myogenic potentials (oVEMPs). METHODS: Forty-two healthy volunteers were included in this prospective study. Subjects with abnormal otological examinations and otological diseases were excluded. oVEMPs were randomly recorded in response to BC 500 Hz narrowband (NB) chirp stimulus and BC 500 Hz tone burst. The stimulus intensity was 50 dB nHL for both 500 Hz tone burst and 500 Hz NB CE chirp stimulus. P1 latency, N1 latency, and N1P1 amplitude were measured, and these measurements were compared between these two types of stimuli. RESULTS: Both types of stimuli elicited oVEMP in all subjects. N1 latency and P1 latency were significantly shorter (6.41 ms vs 10.84 ms; 10.64 ms vs 15.56 ms, respectively) for chirp stimulus (p < 0.05). N1P1 amplitude was significantly higher (11.64 vs 7.18 µV) for NB chirp stimulus (p < 0.05). CONCLUSION: It is reasonable to conclude that the NB CE chirp stimulus is effective to elicit robust BC oVEMP in healthy subjects.

MRI contribution for the detection of endolymphatic hydrops in patients with superior canal dehiscence syndrome.

PURPOSE: Patients with superior semicircular canal dehiscence syndrome, which can only be treated by surgery, present cochleo-vestibular symptoms related to a third-mobile window but also endolymphatic hydrops. Since cVEMP and oVEMP are disturbed by the presence of the dehiscence, the aim of the study is to assess the value of MRI for the diagnosis of endolymphatic hydrops in patients with superior semicircular canal dehiscence syndrome in comparison with cVEMP and oVEMP. METHODS: In this retrospective cohort study we enrolled 33 ears in 24 patients with superior semicircular dehiscence syndrome who underwent a 4-h delayed intravenous Gd-enhanced 3D-FLAIR MRI and pure tone audiometry, cVEMP and oVEMP. For each patient MRI images were evaluated by two radiologists who used a compartmental endolymphatic hydrops grading system in comparison with cVEMP and oVEMP. RESULTS: Endolymphatic hydrops was found on MRI in 9 out of 33 SCDS ears (27.3%). We found no significant correlation between the presence of endolymphatic hydrops on MRI and cVEMP and oVEMP (p = 0.36 and p = 0.7, respectively). However, there was a significant correlation between the presence of endolymphatic hydrops on MRI and the degree of sensorineural hearing loss, Air Conduction-Pure Tone Average level (p = 0.012) and Bone Conduction-Pure Tone Average level (p = 0.09), respectively. CONCLUSION: We demonstrated that EH might be observed in 27.3% of superior semicircular dehiscence syndrome ears. The role of inner ear MRI is important to detect endolymphatic hydrops, since cVEMP and oVEMP are disturbed by the presence of the dehiscence, because these patients could benefit from a medical treatment. LEVEL OF EVIDENCE: Level 3.

The Effect of Cognitive Tasks on the Ocular Vestibular Evoked Myogenic Potentials in Healthy People.

INTRODUCTION: The majority of the daily life activities involve the concurrent performance of simultaneously challenging motor and cognitive activities, such as talking while walking, which requires the vestibular system for balance. Functional balance allows the brain to interpret and integrate the sensory information from our physical and social environment. This study aimed to investigate the effect of cognitive activities on the vestibular system function. MATERIALS AND METHODS: This study investigated the otolith system as a sensory organ that is responsible for linear acceleration by recording ocular vestibular evoked myogenic potential (oVEMP) in 28 healthy participants (11 males and 17 females) with the age range of 18-26 years under a cognitive condition. The rest and intervention states were compared in terms of oVEMP n1-p1 amplitude, n1-p1 latencies, and gender. RESULTS: The results showed that the oVEMP n1-p1 amplitude in both ears significantly decreased, and the asymmetry increased after cognitive tasks, compared to the rest state in females (P≤0.02). Moreover, there was no significant difference between the rest state and numeric subtraction task in terms of oVEMP n1-p1 latencies in males and females (P>0.05). CONCLUSION: These results suggest that an augmented cognitive load causes an alteration in the oVEMPs; therefore, it is suggested that the structures associated with the cognitive processing are connected with the vestibular system in the brain. These findings demonstrate the importance of non-vestibular factors in balance, especially in females.

Topography of the lesion in idiopathic sudden sensorineural hearing loss.

INTRODUCTION: Etiology of ISSNHL includes cessation of vascular perfusion, viral infection and cochlear membrane injury. Precise location of injury should be defined for a target-oriented treatment. Vestibular complaints in ISSNHL are hypothesized as involvement of vestibule. Vestibular complaints can be either due to involvement of inner ear or neural tract at any level. OBJECTIVES: In the present study we aimed to demonstrate involvement of vestibular organs in the absence of vestibular symptoms. It was aimed to evaluate superior and inferior vestibular neural pathways. METHODS: c-vemp and o-vemp were applied to patients suffering ISSNHL without vertigo. Pure tone averages, audiogram configurations, degree of hearing loss were analyzed. Latencies of P1 and N1 waves, amplitudes of P1-N1 waves were evaluated. Asymmetrical vemp wave patterns were compared between two ears regarding difference of PTA. RESULTS: Latencies of c-vemp waves were longer and amplitudes were smaller. o-vemp parameters were similar on both sides. Positive correlation was observed between c-vemp latencies and degree hearing loss. CONCLUSION: Inferior vestibular nerve pathway is affected in the absence of vertigo in ISSNHL with spared superior vestibular nerve pathway. Damage in IVN pathway correlates with degree of ISSNHL.

The relationship between the findings of vestibular evoked myogenic potentials and severity of obstructive sleep apnea syndrome.

PURPOSE: Our study aimed to evaluate the effects of chronic hypoxic state in Obstructive Sleep Apnea Syndrome (OSAS) on brainstem pathways using Vestibular Evoked Myogenic Potential (VEMP) test and to investigate the presence of new markers likely to be correlated with the severity of the disease. METHODS: The study was planned as prospective and double blind. A total of 60 patients (120 ears) diagnosed with mild, moderate and severe OSAS were included in the study and the patients are grouped as 20 patients in each group. Twenty volunteer healthy individuals (40 ears) shown to be without OSAS were included in the study. VEMP measurements were made in 60 study group patients (120 ears) and in 20 healthy controls (40 ears). The groups were compared in terms of variables such as the acquisition rate of oVEMP and cVEMP waves, interval between the waves, latency and amplitude of the waves. p < 0.05 values were considered as significant. RESULTS: The results of cVEMP test showed that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the control group and mild OSAS groups (p = 0.008). There was no difference between the control group and the mild OSAS group in terms of the rate of obtaining the wave (p > 0.05). In the moderate and severe OSAS groups, P1N1 amplitude and N1P2 amplitude values were found to be significantly lower than the mild OSAS group (p = 0.007 and p = 0.017, respectively). In the oVEMP test, there was no significant difference between the mild OSAS group and the control group in terms of the wave yield (p > 0.05); however, it was found that the rate of wave acquisition in the moderate and severe OSAS groups was significantly lower than the mild OSAS group (p = 0.041). There was inverse correlation between the N1P2 interval and P1N1 amplitude value and AHI in simple regression analysis and multiple regression analysis (p = 0.012 and p = 0.021; p = 0.009 and p = 0.040, respectively). CONCLUSION: The negative effects of chronic intermittent hypoxia related with OSAS on the brainstem and vestibular system can be demonstrated by VEMP tests. Especially, the inability to obtain the wave is the most important finding showing this situation. Also, we think that N1P2 interval and P1N1 amplitude markers can be used to detect the subclinical negative effect of chronic hypoxia on vestibular nuclei in the brainstem.

Vestibular evoked myogenic potentials in patients with diabetes mellitus.

Although the exact mechanism and most involved region of the vestibular system have not yet been fully clarified, vestibular dysfunction has been demonstrated in patients with diabetes mellitus (DM). Vestibular evoked myogenic potential (VEMP) is a short latency electromyographic response to sound or vibration stimuli that may reflect otolith organ or related reflex functions. Since its first description in 1992, VEMP has become a significant part of the vestibular test battery as an objective measurement tool. In diabetic patients, VEMP responses have been studied in order to determine any otolith organ or related reflex dysfunctions. Here, we review the literature with regard to VEMP findings representing any peripheral vestibular end-organ dysfunction in patients with DM. Distinctive vestibular end-organ impairments seem to be demonstrated in patients with DM either with or without DNP via objective vestibular testing tools including VEMP recordings according to relevant studies. However, further studies with larger sample sizes are required to reveal the more definitive findings of VEMP recordings regarding the vestibular pathologies in patients with DM.

Correlation between Vestibular Evoked Myogenic Potentials and Disease Progression in Ménière's Disease.

OBJECTIVE: To assess the relationship between ocular (oVEMPs) and cervical (cVEMPs) vestibular evoked myogenic potentials and audiometrically determined clinical stage in Ménière's disease (MD). METHODS: Thirty-four unilateral MD patients and 30 healthy volunteers were included in the study. Pure-tone hearing levels, oVEMPs, cVEMPs, and videonystagmography results were analyzed and compared between the groups. RESULTS: Both oVEMPs and cVEMPs were highly reproducible in the control group. At the early stages of MD, cVEMPs were particularly disturbed, while at the advanced stages both oVEMPs and cVEMPs were altered pathologically. In the study group, oVEMP and cVEMP amplitudes and interaural amplitude difference (IAD) statistically differed from those in the control sample. oVEMPs were absent in 7.7% of stage III and in 44.5% of stage IV MD patients, while cVEMPs were absent in 15.4% of stage III and in 54.5% of stage IV MD patients, respectively. In stage III and IV MD patients in whom oVEMPs and cVEMPs were obtained, IADs were increased. Caloric asymmetry was found in 64.7% of MD patients. Caloric weakness was more prominent in cases with advanced MD. CONCLUSION: VEMPs can be used for objective validation of the stage of MD.

State-of-the-art assessment allows for improved vestibular evoked myogenic potential test-retest reliability.

The goal of the present study was to evaluate the test-retest reliability values of myogenic responses using the latest guidelines for vestibular assessment. Twenty-two otologically and neurologically normal adults were assessed twice, on two different days. The analyses were carried out using interclass correlations. The results showed that the latest recommendations for vestibular assessment lead to test-retest reliability values that are as high, or greater, than those reported in previous studies. The results suggest that state-of-the-art testing, using the latest recommendations as well as electromyography control, improves reliability values of myogenic responses, more specifically for the cervical vestibular evoked myogenic potentials. The impact of small differences in experimental procedures on the reliability values of myogenic responses is also addressed.

Performing and analysing tone-induced cervical and ocular vestibular-evoked myogenic potentials in traumatic and non-traumatic vestibular pathology.

OBJECTIVE: This paper discusses our technique of carrying out cervical and ocular vestibular-evoked myogenic potential testing in a single position. The described technique allows for a symmetrical, natural flexion of the neck muscles, which is helpful as many of our patients have suffered traumatic deceleration injures. METHODS: Patients with suspected vestibular pathology referred by specialists were sequentially assessed in a tertiary referral neuro-otology unit within a teaching hospital using our technique and our previously established normative database. All patients underwent standardised vestibular assessment in addition to cervical and ocular vestibular-evoked myogenic potential assessment. Our normative data are in keeping with that reported by other centres. RESULTS: Many of the patients had abnormal vestibular-evoked myogenic potentials, which is in line with a history suggesting otolithic disease. CONCLUSION: Both cervical and ocular vestibular-evoked myogenic potentials offer several parameters for detecting abnormalities. The technique reported enables us to assess patients in an accurate fashion whether or not they have suffered traumatic neck injuries.

Does blindness affect ocular vestibular evoked myogenic potentials?

OBJECTIVE: The aim of the present study was to investigate the influence of blindness on ocular vestibular evoked myogenic potentials (oVEMP) responses. METHODS: Thirty-one subjects with unilateral blindness (UB group) and 25 age and sex-matched healthy subjects (control group) were recruited for the present study. The oVEMP responses including latency, amplitude and amplitude asymmetry ratio (AR) were measured and compared between the blind side, the contralateral eye of the UB group and the control subjects. RESULTS: Ocular VEMP recordings were obtained from 29 of 31 patients (93.5%) for the blind side of the UB group. There was no significant difference in terms of latency, amplitude and AR value between the blind side and the contralateral eye of the UB group and the control subjects. CONCLUSION: Clear oVEMP recordings can be elicited as long as the eyeball and extraocular muscles are preserved in a blind eye.

Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy.

This study aimed to compare cervical vestibular-evoked myogenic potentials (cVEMP), ocular vestibular-evoked myogenic potentials (oVEMP) and video head impulse test (vHIT) results between patients with type 2 diabetes mellitus (DM) or diabetic polyneuropathy (DPN) and healthy controls to determine vestibular end-organ pathologies. The participants in the present study consisted of three groups: the type 2 DM group (n = 33 patients), the DPN group (n = 33 patients), and the age- and sex-matched control group (n = 35). Cervical VEMP, oVEMP and vHIT were performed for each participant in the study and test results were compared between the groups. Peak-to-peak amplitudes of cVEMP (p13-n21) and oVEMP (n10-p15) were significantly lower in the DM and DPN groups than the control group. The values of vHIT were not statistically different between the groups. To our knowledge, the present study is the first report investigating oVEMP and cVEMP responses combined with vHIT findings in patients with DM and DPN. Vestibular end-organ pathologies can be determined via clinical vestibular diagnostic tools in spite of prominent vestibular symptoms in patients with type 2 DM as well as patients with DPN.

Clinical study of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness / 国际中医中药杂志

Objective To observe the clinical effect of electroacupuncture and Shenmai injection combined with conventional western therapy as treatments for the sudden deafness.Methods A total of 186 patients with sudden deafness were randomly divided into two groups. Each group included 93 patients. The control group was treated with the pipe-expanding and anti-inflammatory, but the treatment group was treated with electroacupuncture and Shenmai injection based on the control group. Both groups were treated for 11 days.Before and after treatments, the regional cerebral blood flow (rCBF) was detected. The MADSEN was used to detect ocular vestibular evoked myogenic potential (oVEMP), including N1-Pl amplitude, N 1-Pl incubation period, N1-Pl wave duration and extraction rate of oVEMP.Results The recovery rate of control group was 63.4% (59/93) and total effective rate was 90.3% (84/93), which was 88.6% (75/93) and 97.8% (91/93) in combined treatment group, and there was significant difference between the 2 groups (χ2=5.923,P<0.05). After 11 days of treatment, the Tinnitus (17.2%vs. 30.1%,χ2=7.152), vertigo and survival rate (15.1%vs. 21.5%, χ2=6.023) in combined treatment group showed significantly lower than those in the control group (P<0.05). The threshold (39.59 ± 5.36 dBHLvs. 45.85 ± 5.08 dBHL,t=2.903) in combined treatment group showed significantly lower than those in the control group (P=0.034). The N1 amplitude (10.62 ± 0.84μVvs. 7.14 ± 0.59μV;t=3.259,P=0.017), P1 amplitude (11.79 ± 0.91μVvs. 9.90 ± 0.82μV;t=2.871,P=0.037), extraction rate of oVEMP (95.7%vs. 81.7%;χ2=7.963,P=0.012) in combined treatment group showed significantly higher than those in the control group. The N1 incubation period (7.86 ± 0.82 msvs. 9.78 ± 1.24 ms;t=3.729,P=0.009) and Pl incubation period (6.57 ± 0.77 msvs. 9.39 ± 1.15 ms;t=3.064,P=0.025) in combined treatment group showed significantly lower than those in the control group.Conclusions The Electroacupuncture and Shenmai injection combined with conventional western therapy could improve blood circulation produce a synergistic therapeutic effect on damaged tissue, improve cochlear hair cells and vestibular nerve regeneration, and repaire the functions.