Low Amplitude of Ocular Vestibular-Evoked Myogenic Potentials Can Denote Poor Prognosis in Patients with Idiopathic Sudden Sensorineural Hearing Loss

Yıl 2024, Cilt: 34 Sayı: 3, 71 - 76, 30.09.2024

Ayça Başkadem Yılmazer , Sitare Sabire Sarıçam , Güler Berkiten , Öykü İzel Onaran , Melis Ece Arkan Anarat , Belgin Tutar , Hüseyin Sarı , Ömür Biltekin Tuna

https://doi.org/10.26650/Tr-ENT.2024.1464970

Öz

Objective: To assess vestibular evoked myogenic potentials (VEMP), both cervical (c-VEMP) and ocular (o-VEMP), in patients diagnosed with unilateral sudden hearing loss and presenting with vestibular symptoms and to determine whether these responses can serve as predictive parameters for recovery.

Materials and Methods: Patients diagnosed with unilateral sudden sensorineural hearing loss (SSHL) and vertigo and healthy volunteers without ear pathology were included. All participants underwent ear tests, including pure tone audiometry and c-VEMP and o-VEMP tests.

Results: When comparing the VEMP values of the patients who showed improved hearing with those who did not, it was observed that the o-VEMP amplitude of non-improved patients was statistically lower (p=0.013). Moreover, in the non-improved group, the c-VEMP P1 latencies were lower, and the amplitude asymmetry ratio (AAR) of c-VEMP was significantly higher than that in the control group, significantly (p=0.006 and p<0.001, respectively; Mann Whitney U test with Bonferroni Correction p<0.017).

Conclusion: In patients with SSHL and vertigo, VEMP testing is beneficial for detecting the vestibular component of the disease. There was no asymmetry in VEMP responses between the affected and unaffected ear sides. Patients with SSHL who have vertigo have poor hearing loss recovery rates in the case of low-amplitude o-VEMP responses.

Anahtar Kelimeler

Hearing loss sudden, vestibular evoked myogenic potentials, prognosis

Kaynakça

• Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, et al. American Academy of Otolaryngology-Head and Neck Surgery Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(3 Suppl):1-35. google scholar
• Castro TM, Costa LA, Nemezio ME, Fonseca LJ. Bilateral sudden deafness. Braz J Otorhinolaryngol 2011;77(5):678. google scholar
• Iwasaki S, Takai Y, Ozeki H, Ito K, Karino S, Murofushi T. Extent of lesions in idiopathic sudden hearing loss with vertigo: study using click and galvanic vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg 2005;131(10):857-62. google scholar
• Yoon TH, Paparella MM, Schachern PA, Alleva M. Histopathology of sudden hearing loss. Laryngoscope 1990;100(7):707-15. google scholar
• Shaia FT, Sheehy JL. Sudden sensori-neural hearing impairment: a report of 1,220 cases. Laryngoscope 1976;86(3):389-98. google scholar
• Nakashima T, Yanagita N. Outcome of sudden deafness with and without vertigo. Laryngoscope 1993;103(10):1145-9. google scholar
• Rosengren SM, Welgampola MS, Colebatch JG. Vestibular evoked myogenic potentials: past, present and future. Clin Neurophysiol 2010;121(5):636-51. google scholar
• Rosengren SM, Kingma H. New perspectives on vestibular evoked myogenic potentials. Curr Opin Neurol 2013;26(1):74-80. google scholar
• Murofushi T, Matsuzaki M, Mizuno M. Vestibular evoked myogenic potentials in patients with acoustic neuromas. Arch Otolaryngol Head Neck Surg 1998;124(5):509-12. google scholar
• Murofushi T. Clinical application of vestibular evoked myogenic potential (VEMP). Auris Nasus Larynx 2016;43(4):367-76. google scholar
• Iwasaki S, McGarvie LA, Halmagyi GM, Burgess AM, Kim J, Colebatch JG, et al. Head taps evoke a crossed vestibulo-ocular reflex. Neurology 2007;68(15):1227-9. google scholar
• Cheng YF, Chu YC, Tu TY, Shiao AS, Wu SL, Liao WH. Modified Siegel’s criteria for sudden sensorineural hearing loss: Reporting recovery outcomes with matched pretreatment hearing grades. J Chin Med Assoc 2018;81(11):1008-12. google scholar
• Khan FK, Balraj A, Lepcha A. Normative data for vestibular evoked myogenic potential in different age groups among a heterogeneous Indian population. Indian J Otolaryngol Head Neck Surg 2014;66(2):149-54. google scholar
• Jha RH, Piker EG, Romero D. Effects of Age and Middle Ear on the Frequency Tuning of the cVEMP and oVEMP. J Am Acad Audiol 2022;33(5):259-69. google scholar
• Lee HS, Song JN, Park JM, Park KH, Kim HB, Seo JH. Association between Vestibular Function and Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss. Korean J Audiol 2014;18(3):131-6. google scholar
• Niu X, Zhang Y, Zhang Q, Xu X, Han P, Cheng Y, et al. The relationship between hearing loss and vestibular dysfunction in patients with sudden sensorineural hearing loss. Acta Otolaryngol 2016;136(3):225-31. google scholar
• Pogson JM, Taylor RL, Young AS, McGarvie LA, Flanagan S, Halmagyi GM, et al. Vertigo with sudden hearing loss: audio-vestibular characteristics. J Neurol 2016 Oct;263(10):2086-96. google scholar
• Argaet EC, Kwok BYC, Bradley J, Young AS, Nham B, Calic Z, et al. Subjective visual horizontal correlates better with ocular than with cervical vestibular evoked myogenic potentials. Clin Neurophysiol 2023;152:1-10. google scholar
• Liang M, Wu H, Chen J, Zhang Q, Li S, Zheng G, et al. Vestibular evoked myogenic potential may predict the hearing recovery in patients with unilateral idiopathic sudden sensorineural hearing loss. Front Neurol 2022;13:1017608. google scholar
• Jiang Z, Zhang J, Wang Y, Huang X, Yao Q, Feng Y, et al. Contribution of Audiogram Classification in Evaluating Vestibular Dysfunction in Sudden Sensorineural Hearing Loss with Vertigo. Front Neurol 2021;12:667804. google scholar
• Lim KH, Jeong YJ, Han MS, Rah YC, Cha J, Choi J. Comparisons among vestibular examinations and symptoms of vertigo in sudden sensorineural hearing loss patients. Am J Otolaryngol 2020;41(4):102503. google scholar
• Yigider AP, Keskin M, Kufeciler L, Kocak HE. Topography of the lesion in idiopathic sudden sensorineural hearing loss. Acta Otolaryngol 2020;140(11):909-13. google scholar
• Kizkapan DB, Karlidag T, Basar F, Kaygusuz I, Keles E, Akyigit A, et al. Vestibular functions in patients with idiopathic sudden sensorineural hearing loss and its relation to prognosis. Auris Nasus Larynx 2022;49(3):374-82. google scholar