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Vestibular Evoked Myogenic Potentials with Compressed High-Intensity Radar Pulse Stimuli: A Literature Review
Sıkıştırılmış Yüksek Yoğunluklu Radar Titreşimi Uyaranıyla Vestibüler Uyarılmış Miyojenik Potansiyeller: Literatür Derlemesi
Received Date : 29 Jan 2024
Accepted Date : 19 Mar 2024
Available Online : 22 Apr 2024
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Berna Deniz KUNTMANa, Anı PARABAKAN POLATa
aUniversity of Health Sciences Gülhane Faculty of Health Sciences, Department of Audiology, Ankara, Türkiye
Doi: 10.24179/kbbbbc.2024-101714 - Article's Language: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(2):96-102
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
Vestibular evoked myogenic potentials (VEMPs) are commonly used noninvasive electrophysiological test methods in clinics. VEMPs are short-latency muscle reflex responses triggered by stimulation of peripheral otolith organs. The inhibitory myogenic response measured over the sternocleidomastoid muscle is cervical VEMP (cVEMP); the excitatory myogenic response measured over the extraocular muscles, the inferior oblique, is the ocular VEMP (oVEMP). cVEMP is characterized by a biphasic wave in the form of one positive peak (P1/P13) occurring at an average of 13th milliseconds and one negative peak (N1/N23) occurring at an average of 23rd milliseconds. oVEMP is characterized by a biphasic wave in the form of one negative peak (N1/N10) occurring at an average of 10th milliseconds and one positive peak (P1/P16) occurring at an average of 16th milliseconds. Stimulus type affects the VEMP findings. Click stimulus was first used in VEMP studies. The stimulus that effectively stimulates the otolith organs and generates the highest amplitude waves is being investigated. 500 Hertz (Hz) tone burst stimulus is more effective than click stimulus in VEMP tests and its clinical use has become widespread. Compressed high-intensity radar pulse (CHIRP) is an acoustic stimulus that is effective in auditory electrophysiology. VEMP in responses to CHIRP stimulus was reported in recent studies. In this review, the findings of studies examining VEMP responses triggered by CHIRP stimuli are integrated. The aim of this review is to evaluate whether the CHIRP stimulus is an effective stimulus in VEMP tests.
Keywords: Vestibular evoked myogenic potentials; cervical vestibular evoked myogenic potentials; ocular vestibular evoked myogenic potentials; compressed high-intensity radar pulse
ÖZET
Vestibüler uyarılmış miyojenik potansiyeller [vestibular evoked myogenic potentials (VEMP)], ses, titreşim veya elektriksel stimülasyonla periferik otolit organların uyarılması sonucu tetiklenen kısa latanslı kas refleks cevaplarıdır. VEMP klinikte yaygın olarak kullanılan noninvaziv elektrofizyolojik test yöntemidir. Sternokleidomastoid kas üzerinden ölçülen inhibitör miyojenik yanıt servikal VEMP (sVEMP); inferior oblik üzerinden kaydedilen eksitatör miyojenik yanıt oküler VEMP (oVEMP) olarak adlandırılır. sVEMP 13. milisaniyede ortaya çıkan bir pozitif tepe (P13/ P1), ortalama 23. milisaniyede ortaya çıkan negatif tepe (N23/N1) şeklinde bifazik dalga formu ile karakterizedir. oVEMP, 10. milisaniyede ortaya çıkan negatif tepe (N10/N1) ile 16. milisaniyede ortaya çıkan pozitif tepe (P16/P1) şeklinde bifazik dalga formu ile karakterizedir. sVEMP bulgularında P1, N1 latansları, P1-N1 dalga amplitüdü değerlendirilir. oVEMP bulgularında N1, P1 latansları, N1-P1 dalga amplitüdü değerlendirilir. Kullanılan uyaranın türü VEMP bulgularını etkiler. İlk VEMP çalışmalarında klik uyaran kullanılmıştır. Otolit organları en etkili şekilde uyaran ve yüksek amplitüdlü dalgalar oluşturan uyaran araştırılmaktadır. VEMP testlerinde 500 Hertz (Hz) tone burst (TB) uyaranının klik uyarana göre daha etkili bir uyaran olduğu gösterilmiştir. 500 Hz TB uyaranının klinik kullanımı yaygınlaşmıştır. Sıkıştırılmış yüksek yoğunluklu radar titreşimi [compressed high-intensity radar pulse (CHIRP)], işitsel elektrofizyolojide etkili olduğu gösterilen akustik bir uyarandır. CHIRP uyaran, son yıllarda, VEMP testlerinde kullanılmaya başlanmıştır. Bu derlemede, CHIRP uyaranla tetiklenen VEMP yanıtlarını inceleyen çalışmaların bulguları entegre edilmiştir. Bu derlemenin amacı, CHIRP uyaranın VEMP testlerinde etkili bir uyaran olup olmadığını değerlendirmektir.
Keywords: Vestibüler uyarılmış miyojenik potansiyeller; servikal vestibüler uyarılmış miyojenik potansiyeller; oküler vestibüler uyarılmış miyojenik potansiyeller; sıkıştırılmış yüksek yoğunluklu radar titreşimi
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