ISSN 1612-3352

Editors in Chief

Prof. Dr. Claus F. Claussen, Neurootological Research Institute of the Research Society for Smell, Taste, Hearing and Equilibrium Disorders at Bad Kissingen (4-G-F). Bad Kissingen, Germany.
Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.

Production Managers

Dr. med. Julia M. Bergmann,
Dr. med. Guillermo O. Bertora,
Otoneuroophthalmological Neurophysiology,
Buenos Aires, Argentina.


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Vestibular evoked myogenic potentials in meniere’s disease

Abstract

Objective: Staging of Meniere’s disease proposed by AAO-HNS (1995) was based on the arithmetic mean of the pure tone thresholds at 0.5, 1, 2, and 3kHz, using the worst audiogram during the interval six months before treatment. Accordingly, stage I means four-tone average less than 26 dB; stage II, 26-40 dB, stage III, 41-70 dB, and stage IV, more than 70 dB. Since saccule, next to cochlea, is the second most frequent site for hydrops formation, whether vestibular evoked myogenic potential (VEMP) responses can reflect the stage of Meniere’s disease remains unexplored.
Design: Prospective study
Patients: Forty patients (23 men and 17 women, mean age: 43 + 12 years) with unilateral definite Meniere’s disease were enrolled in this study.
Main Outcome Measures: The latencies of p13 and n23, amplitude p13-n23, and the interaural amplitude difference (IAD) over the sum of amplitudes of both ears were measured, and the stages of the disease were compared with the types of hearing loss, the % unilateral weakness of caloric response, and the IAD ratio, respectively.
Results: Six ears were classified as stage I, including normal VEMPs in 5 and augmented VEMPs in 1, with a mean IAD ratio -0.02 + 0.20. Twelve ears of stage II consisted of normal VEMPs in 7, augmented VEMPs in 2, depressed VEMPs in 1, and absent VEMPs in 2, with a mean IAD ratio -0.12 + 0.39. Stage III was noted in 17 ears, including normal VEMPs in 10, depressed VEMPs in 4, and absent VEMPs in 3, with a mean IAD ratio -0.30 + 0.30 . Stage IV was in 5 ears, including normal VEMPs in 2, depressed VEMPs in 1, and absent VEMPs in 2, with a mean IAD ratio -0.54 + 0.43. Comparing the IAD ratio and the stage of Meniere’s disease demonstrates a significant relationship (p<0.05, ANOVA test), whereas no significant relationship exists between the % unilateral weakness of caloric response and the stage of disease. Conclusions: The IAD ratio of VEMPs correlates with the stage of Meniere’s disease, and can be served as another aid to assess the stage of Meniere’s disease.

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