Abstract
: ObjectiveCompare the sensitivity and specificity of cVEMP (500 Hz), oVEMP (500 Hz and 4 kHz) in the identification of SSCD. A secondary objective was to identify the influence of dehiscence size and location on cVEMP and oVEMP responses. Methods: Individuals with unilateral (n = 16) and bilateral (n = 10) scan confirmed SSCD were assessed using air-conducted cVEMP and oVEMP Results: For cVEMP, an amplitude cutoff of 286.9 μV or a threshold cutoff of 67.5 dBnHL revealed, respectively, a sensitivity of 75% and 70.6% and a specificity of 69.4% and 100%. For oVEMP (500 Hz), an amplitude cutoff of 10.8 μV or a threshold cutoff of 77.5 dBnHL revealed a sensitivity of 83.33% and a specificity of 87.5% and 80%, respectively. oVEMP (4 kHz), an amplitude cutoff of 3.1 μV, revealed a high specificity of 100% but a low sensitivity of 47.2%. A positive correlation was noted between the length of the SSCD and the cVEMP and oVEMP (500 Hz) thresholds and cVEMP amplitude. Conclusions: Our results support the use of oVEMP in the identification of SSCD. The presence of oVEMP (500 Hz) with an amplitude higher or equal to 10.8 μV, a threshold lower or equal to 77.5 dBnHL or oVEMP (4 kHz) amplitude of 3.1 μV represents the most useful to identify SSCD.
Highlights
The peripheral vestibular system, located in the inner ear, comprises three semicircular canals and two otolithic organs, which, respectively, detect angular and linear accelerations of the head [1]
The use of the ocular vestibular evoked myogenic potential (oVEMP) (500 Hz) threshold and amplitude in the identification of superior semicircular canal dehiscence (SSCD) as as they revealed the highest sensitivity and specificity using a cutoff of 77.5 dBnHL and they revealed the highest sensitivity and specificity using a cutoff of 77.5 dBnHL and 10.8
This is in line with previous findings suggesting high sensitivity and specificity of tone-burst oVEMP in the identification of SSCD [10,11,12,23]
Summary
The peripheral vestibular system, located in the inner ear, comprises three semicircular canals (superior, horizontal and posterior) and two otolithic organs (utricle and saccule), which, respectively, detect angular and linear accelerations of the head [1]. It has been demonstrated that otolithic organs could be stimulated using sound and vibration [2]. This sensitivity to sound and vibration has led to the development of a well-documented clinical test, the vestibular evoked myogenic potential (VEMP). Two subtypes of VEMP responses are most commonly used: the cervical vestibular evoked myogenic potential (cVEMP) and the ocular vestibular evoked myogenic potential (oVEMP). The cVEMP is an inhibitory response measured at the level of the ipsilateral sternocleidomastoid muscle assessing the function of the sacculo-colic pathway [3]. The oVEMP is an excitatory response measured at the level of the contralateral inferior oblique muscle, which measures the function of the utriculo-ocular pathway [4]. Giving its widespread accessibility in clinical and research settings, there was a growing interest in cVEMP and oVEMP use in the identification of multiple vestibular diseases [5]
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