Air and bone stimulation in vestibular evoked myogenic potentials in patients with unilateral Ménière’s disease and in controls

Abstract

Objectives: To describe the vestibular evoked myogenic potential (VEMP) response to air-conducted sound (ACS) and bone-conducted vibration (BCV) in patients with unilateral definite Ménière's disease (MD), and the contribution to the usual ACS evaluation of the bone-air index (BAI) and interaural asymmetry ratio (IAR) in the diagnosis.Methods: A case–control study was designed. Fifty-one patients (25 men and 26 women) with an average age of 55 years, and 31 healthy volunteers with no history of vertigo and hearing loss, were included. The BAI was used as a new parameter to describe the amplitude of the response.Results: Only n10 latency ACS evoked was significantly longer than in controls. The ACS cVEMP p13-n23 amplitude of the affected ear of patients with MD was lower than in the non-affected ear (p = .023) and the control group (.001). The IAR was significantly higher in patients with MD both for the ACS and for the BCV cVEMP compared to the control group: p = .004 and .001, respectively. Significant differences were found in oVEMP n10-p16 amplitude between ACS and BCV in the patients with MD (p = .002). The BAI in oVEMP showed a significant increase in the affected ear compared to the control group (p = .001). The acoustic stimulus in cVEMP was the only one that showed significant differences in amplitude according to degree of hearing loss (p = .039).Conclusions: The joint use of an acoustic and vibratory stimulus is an interesting option to characterize the results in this group. The BAI provides useful complementary information, and also turns out to give added value to the traditional VEMP assessment by ACS. We recommend its use when Ménière's disease is suspected.