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ORIGINAL RESEARCH

Vestibular-Evoked Myogenic Potential Findings in Patients with Unilateral Idiopathic Sudden Sensorineural Hearing Loss
Tek Taraflı Ani İşitme Kayıplı Hastalarda Vestibüler Uyarılmış Miyojenik Potansiyel Bulguları
Received Date : 09 Jan 2020
Accepted Date : 21 Feb 2020
Available Online : 27 Feb 2020
Doi: 10.24179/kbbbbc.2020-73470 - Makale Dili: EN
KBB ve BBC Dergisi. 2020;28(3):240-6
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: We investigated vestibular function in patients with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL) and vertigo, and assessed the relationship between hearing loss grade and cervical vestibular-evoked myogenic potentials (cVEMPs) and ocular VEMP (oVEMPs) findings. Material and Methods: The study included 31 patients diagnosed with unilateral ISSNHL and vertigo, and 26 healthy individuals (control group) with VEMP. In all participants, pure tone audiometry was used to assess the hearing threshold, and cVEMP and oVEMP tests were used to assess vestibular system function. The P1/N1 latency, P1-N1 interval and amplitude asymmetry ratio (AAR) were measured in the VEMP test. Additionally, the relationship between the VEMP findings and the degree of hearing loss was assessed. Results: We found no significant differences in VEMP parameters (N1 latency, P1-N1 interval, and amplitude) between the affected and control group ears (p>0.05). In contrast, the cVEMP P1 latency and AARs were significantly different between the patient and control groups (p=0.019 and 0.015, respectively). No significant differences were found in VEMP parameters (P1 latency, N1 latency, P1-N1 interval, and amplitude) or AAR in the patients with profound and nonprofound hearing loss in the cVEMP and oVEMP tests (p>0.05). Conclusions: Vestibular otolithic dysfunction can be detected using cVEMP and oVEMP in patients with ISSHL and vertigo. The VEMP amplitude asymmetry and VEMP responses have high diagnostic value in patients with ISSNHL with vestibular symptoms. Abnormal cVEMP responses provide more information than oVEMP responses about vestibular otolithic damage in patients with ISSHL. Although the saccule and utricle were affected in ISSNHL, the extent of saccular and utricular damage did not correspond to the amount of hearing loss.
ÖZET
Amaç: Tek taraflı idiyopatik ani sensorinöral işitme kaybı (ISSNHL) ve vertigo hastalarında vestibüler fonksiyonu araştırdık ve işitme kaybı derecesi ile servikal vestibüler uyarılmış miyojenik potansiyel (cVEMP) ve oküler VEMP (oVEMP) bulguları arasındaki ilişkiyi değerlendirdik. Gereç ve Yöntemler: Çalışmaya tek taraflı ISSNHL ve vertigo tanısı konmuş 31 hasta ve VEMP'li 26 sağlıklı birey (kontrol grubu) dahil edildi. Tüm katılımcılarda işitme eşiğini değerlendirmek için saf ses odyometrisi, vestibuler sistem fonksiyonunu değerlendirmek için cVEMP ve oVEMP testleri kullanıldı. VEMP testinde P1/N1 latansı, P1-N1 aralığı, ve Amplitüd asimetrisi oranı (AAR) ölçüldü. Ayrıca VEMP bulguları ile işitme kaybı derecesi arasındaki ilişki değerlendirildi. Bulgular: Etkilenen ve kontrol grubu kulakları arasında VEMP parametrelerinde (N1 latans, P1-N1 aralığı ve amplitüd) önemli bir fark bulamadık (p> 0,05). Buna karşılık, cVEMP P1 latansı ve AAR hasta ve kontrol grupları arasında anlamlı olarak farklıydı (sırasıyla p = 0,019 ve 0,015). cVEMP ve oVEMP testlerinde derin ve kanıtlanmamış işitme kaybı olan hastalarda VEMP parametreleri (P1 latansı, N1 latansı, P1-N1 aralığı ve amplütüd) veya AAR'da anlamlı fark bulunmadı (p> 0,05). Sonuç: Vestibüler otolitik disfonksiyon ISSHL ve vertigo hastalarında cVEMP ve oVEMP kullanılarak tespit edilebilir. Vestibüler semptomları olan ISSNHL hastalarında VEMP amplitüd asimetrisi ve VEMP yanıtları yüksek tanı değerine sahiptir. Anormal cVEMP yanıtları ISSHL hastalarında vestibüler otolitik hasarla ilgili oVEMP yanıtlarından daha fazla bilgi sağlar. Her ne kadar sakkülve utrikul ISSNHL'de etkilenmiş olsa da, sakküler ve utriküler hasarın derecesi işitme kaybı derece ile korele değildir.
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