07 February 2014 : Research paper
Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosisOurania TramontaniABDEFG, Eleni GkoritsaCDEF, Eleftherios FerekidisAD, Stavros G. KorresADFG
Med Sci Monit 2014; 20:205-213
BACKGROUND: 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 AND 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.
Keywords: Osteosclerosis, Audiometry, Pure-Tone, Hearing Loss, Conductive, Acoustic Stimulation, Diagnosis, Differential, Ear Diseases - diagnosis, Greece, Otosclerosis - diagnosis, Prospective Studies, Vestibular Evoked Myogenic Potentials - physiology
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