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Clinical value of tone burst vestibular evoked myogenic potentials at threshold in acute and stable Ménière's disease

Published online by Cambridge University Press:  03 July 2007

V Osei-Lah ,
B Ceranic  and
L M Luxon
V Osei-Lah*
Affiliation:
Department of Neuro-Otology, National Hospital for Neurology and Neurosurgery, London, UK
B Ceranic
Affiliation:
Department of Audiological Medicine, St George's Hospital and Medical School, London, UK
L M Luxon
Affiliation:
Department of Neuro-Otology, National Hospital for Neurology and Neurosurgery, London, UK
*
Address for correspondence: Dr Victor Osei-Lah, 61 Ridgewell Close, London SE26 5AP, UK. Fax: 0208 2962704 E-mail: [email protected]
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Abstract

Introduction:

The objectives of this preliminary, prospective, cohort study were to ascertain the characteristics of vestibular evoked myogenic potentials at threshold levels in two groups of Ménière's disease patients – acute and stable – and to identify whether vestibular evoked myogenic potentials can provide any specific, objective information to distinguish acute from stable Ménière's disease.

Subjects and methods:

The study was based at a tertiary neuro-otology centre. Twenty adult patients who fulfilled the American Academy of Otolaryngology–Head and Neck Surgery1 criteria for Ménière's disease were divided into two groups: 11 patients with acute Ménière's disease and nine patients with stable Ménière's disease. Eighteen healthy adult volunteers served as controls. All subjects underwent vestibular evoked myogenic potential testing with ipsilateral, short tone burst stimuli at 500 Hz, as well as pure tone audiometry. The patients also underwent caloric testing.

Results:

Vestibular evoked myogenic potentials were present in all controls, and were present in 65 per cent of patients but absent in 35 per cent. The mean absolute threshold (Tvestibular evoked myogenic potential) ± standard deviation in normal controls was 116 ± 7.7 dBSPL; this did not differ statistically from that in patients, nor did it differ between acute and stable Ménière's disease. The p13/n23 latencies at the threshold levels in the normal, acute and stable groups (mean ± standard deviation) were respectively: 15 ± 2.2 ms/23.0 ± 2.5 ms; 15.7 ± 0.9 ms/23.7 ± 0.9 ms; and 15.3 ± 2.0 ms/24.2 ± 1.9 ms. The mean interaural amplitude difference ratio (IAD) ± standard deviation was significantly higher in the stable group compared with the acute group (0.54 ± 0.33 vs −0.15 ± 0.22; p = 0.007) and with the controls (0.54 ± 0.33 vs 0.1 ± 0.22; p = 0.05).

Conclusions:

The parameter that best differentiated acute from stable Ménière's disease at threshold was the interaural amplitude difference ratio. Therefore, this parameter may be used to monitor the clinical course of Ménière's disease.

Keywords

Ménière's DiseaseEvoked PotentialsVestibular Function Tests
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 5 , May 2008 , pp. 452 - 457
Copyright
Copyright © JLO (1984) Limited 2007

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Footnotes

Excerpts presented at the 5th British Society of Neuro-otology Meeting, 10 October 2005, Imperial College, London, and at the Ménière's Society (UK) Annual Conference, 17 October 2006, London.

References

1 Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. American Academy of Otolaryngology–Head and Neck and Surgery, Inc (AAOHNS). Otolaryngol Head Neck Surg 1995;113:181–5Google Scholar
2 McCue, MP, Guinan, JJ. Acoustically responsive fibres in the vestibular nerve of the cat. J Neurosci 1994;14:6058–70CrossRefGoogle ScholarPubMed
3 Murofushi, T, Curthoys, IS, Topple, AN, Colebatch, JG, Halmagyi, GM. Responses of guinea pig primary vestibular neurons to clicks. Exp Brain Res 1995;103:174–8CrossRefGoogle ScholarPubMed
4 Okuno, T, Sando, I. Localization, frequency, and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in Meniere's disease. Ann Otol Rhinol Laryngol 1987;96:438–45CrossRefGoogle ScholarPubMed
5 Sando, I, Orita, Y, Hirsch, BE. Pathology and pathophysiology of Meniere's disease. Otolaryngol Clin North Am 2002;35:517–28CrossRefGoogle ScholarPubMed
6 de Waele, C, Tran, Ba Huy, P, Diard, JP, Freyss, G, Vidal, PP. Saccular dysfunction in Meniere's patients. A vestibular-evoked myogenic potential study. Ann N Y Acad Sci 1999;871:392–7CrossRefGoogle ScholarPubMed
7 Seo, T, Node, M, Yukimasa, A, Sakagami, M. Furosemide loading vestibular evoked myogenic potential for unilateral Meniere's disease. Otol Neurotol 2003;24:283–8CrossRefGoogle ScholarPubMed
8 Seo, T, Yoshida, K, Shibano, A, Sakagami, M. A possible case of saccular endolymphatic hydrops. ORL J Otorhinolaryngol Relat Spec 1999;61:215–18CrossRefGoogle ScholarPubMed
9 Young, YH, Huang, TW, Cheng, PW. Vestibular evoked myogenic potentials in delayed endolymphatic hydrops. Laryngoscope 2002;112:1623–6CrossRefGoogle ScholarPubMed
10 Wang, SJ, Young, YH. Vestibular evoked myogenic potentials using simultaneous binaural acoustic stimulation. Hear Res 2003;185:43–8CrossRefGoogle ScholarPubMed
11 Young, YH, Huang, TW, Cheng, PW. Assessing the stage of Meniere's disease using vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg 2003;129:815–18CrossRefGoogle ScholarPubMed
12 Wu, CL, Young, YH. Vestibular evoked myogenic potentials in acute low-tone sensorineural hearing loss. Laryngoscope 2004;114:2172–5CrossRefGoogle ScholarPubMed
13 Kuo, S-H, Yang, T-H, Young, YH. Changes in vestibular evoked myogenic potentials after Menière attacks. Ann Otol Rhinol Laryngol 2005;114:717–21CrossRefGoogle ScholarPubMed
14 Rauch, SD, Silveira, MB, Zhou, G, Kujawa, SG, Wall, C 3rd, Guinan, JJ et al. Vestibular evoked myogenic potentials versus vestibular test battery in patients with Meniere's disease. Otol Neurotol 2004;25:981–6CrossRefGoogle ScholarPubMed
15 Lin, MY, Timmer, FC, Oriel, BS, Zhou, G, Guinan, JJ, Kujawa, SG et al. Vestibular evoked myogenic potentials (VEMP) can detect asymptomatic saccular hydrops. Laryngoscope 2006;116:987–92CrossRefGoogle ScholarPubMed
16 British Society of Audiology. Recommended procedure for tympanometry. Br J Audiol 1992;26:255–7CrossRefGoogle Scholar
17 Kemp, DT, Ryan, S, Bray, P. A guide to effective use of otoacoustic emissions. Ear Hear 1990;11:93–105CrossRefGoogle ScholarPubMed
18 British Society of Audiology. Recommended procedure for caloric test. Br J Audiol 1999;33:179–84CrossRefGoogle Scholar
19 Rauch, SD, Zhou, G, Kujawa, SG, Guinan, JJ, Herrmann, BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière's disease. Otol Neurotol 2004;25:333–8CrossRefGoogle ScholarPubMed
20 Todd, NP, Cody, FW, Banks, JR. A saccular origin of frequency tuning in myogenic vestibular evoked potentials?: implications for human responses to loud sounds. Hear Res 2000;141:180–8CrossRefGoogle ScholarPubMed
21 Murofushi, T, Matsuzaki, M, Wu, CH. Short tone burst-evoked myogenic potentials on the sternocleidomastoid muscle: are these potentials also of vestibular origin? Arch Otolaryngol Head Neck Surg 1999;125:660–4CrossRefGoogle ScholarPubMed
22 Welgampola, MS, Colebatch, JG. Characteristics of tone burst-evoked myogenic potentials in the sternocleidomastoid muscles. Otol Neurotol 2001;22:796–802CrossRefGoogle ScholarPubMed
23 Node, M, Seo, T, Miyamoto, A, Adachi, A, Hashimoto, M, Sakagami, M. Frequency dynamic shift of vestibular evoked myogenic potentials in patients with endolymphatic hydrops. Otol Neurotol 2005;26:1208–13CrossRefGoogle ScholarPubMed
24 Murofushi, T, Shimizu, K, Takegoshi, H, Cheng, PW. Diagnostic value of prolonged latencies in the vestibular evoked myogenic potential. Arch Otolaryngol Head Neck Surg 2001;127:1069–72CrossRefGoogle ScholarPubMed
25 Ochi, K, Ohashi, T, Nishino, H. Variance of vestibular-evoked myogenic potentials. Laryngoscope 2001;111:522–7CrossRefGoogle ScholarPubMed
26 Alpini, D, Pugnetti, L, Caputo, D, Cesarani, A. Vestibular evoked myogenic potentials in multiple sclerosis: a comparison between onset and definite cases. Int Tinnitus J 2005;11:48–51Google ScholarPubMed
27 Akkuzu, G, Akkuzu, B, Ozlouglu, L. Vestibular evoked myogenic potentials in benign paroxysmal positional vertigo and Meniere's disease. Eur Arch Otorhinolaryngol 2006;263:510–17CrossRefGoogle ScholarPubMed
28 Spoendlin, H, Balle, V, Bock, G, Bredberg, G, Danckwardt-Lillierstrom, N, Felix, H et al. Multicentre evaluation of the temporal bones obtained from a patient with suspected Menière's disease. Acta Otolaryngol Suppl 1992;499:1–21CrossRefGoogle ScholarPubMed
29 Kitamura, K, Takahashi, K, Kakoi, H, Sugimoto, T, Silverstein, H. A morphological and morphometric study of the peripheral process of the human vestibular nerve following posterior cranial neurectomy. J Laryngol Otol 1999;113:967–72CrossRefGoogle Scholar
30 Ylikoski, J, Collan, Y, Palva, T. Vestibular nerve in Menière's disease. Arch Otolaryngol 1980;106:477–83CrossRefGoogle ScholarPubMed
31 Kitamura, K, Kaminaga, C, Ishida, T, Silverstein, H. Ultrastructural analysis of the vestibular nerve in Menière's disease. Auris Nasus Larynx 1997;24:27–30CrossRefGoogle ScholarPubMed