Vestibular evoked myogenic potentials testing for diagnosing Sudden Sensorineural Hearing Loss

Abstract

Sudden sensorineural hearing loss is an emergency condition in otolaryngology. In most cases it manifests as a unilateral reduction in hearing. In addition to hearing loss in one ear, patients often have symptoms such as vertigo and/or tinnitus. The follow-up of patients with sudden sensorineural hearing loss should include not only testing of the hearing system but also diagnosis of the vestibular apparatus. VEMP is an objective method for assessment of the vestibular function through the reaction of the reflex muscle in response to high-intensity acoustic stimulation.
Materials and methods: The subject of study are 12 patients with sudden hearing loss where 5 of the followed patients also complaining of vertigo and instability. After taking a history, the following are performed: examination of ENT organs, pure-tone audiometry, OAE, tympanometry with acoustic reflex, otoneurological examination, VEMP tests, CT (MRI).
Results: Patients with severe sudden hearing loss have deviations in their VEMP tests. The hearing recovery percentage is lower with abnormal VEMP than in those with normal VEMP.
Conclusion: Patients with deviations in VEMP tests can have vestibular disorders in addition to lesions in the organ of Corti, including stria vascularis and the tectorial membrane. There is an association between pathological VEMP and the level of hearing reduction. Abnormal VEMP can be used to predict subsequent incomplete hearing recovery.