Is cervical vestibular evoked myogenic potentials an effective tool for the evaluation of saccular function in patients suffering from peripheral vertigo? An analytical study

Abstract

Introduction: Vertigo, a multisensory symptom, is one of the most common presentations to otolaryngology clinic and may occur in a multitude of ENT-related diseases, thus making a correct diagnosis challenging. In the last few decades, there has been a paradigm shift in the diagnostics of vertigo due to the availability of better objective modalities that allow assessment of different components of the complex vestibular labyrinth with relative ease. With the advent of vestibular evoked myogenic potentials (VEMP) since the last few decades, it is possible to test otolith organs in isolation and objectively. Aim: The aim of this study is to study the effectiveness of cervical VEMP (cVEMP) in the evaluation of saccular function in patients suffering from peripheral vertigo. Study Design: Analytical cross-sectional study. Setting: Tertiary care hospital. Materials and Methods: The study was conducted over a period of 2 years, from December 2016 to October 2018 at the ENT department of a tertiary care hospital. A sample size of 40 patients of peripheral vertigo and 40 age-matched healthy controls was selected. Air conduction cVEMP was performed in cases of posterior canal benign paroxysmal positional vertigo (pBPPV), vestibular neuritis (VN), superior semicircular canal dehiscence syndrome (SCD), and Meniere's disease (MD) and their values were compared with contralateral healthy ears and controls. Results: cVEMP parameters in VN, SCD, and MD were found to be abnormal, and the difference from normal was statistically significant. However, in the case of pBPPV patients, they did not show any difference from the normal. Conclusion: cVEMP is found to be a useful screening tool for conditions such as VN, SCD, and MD.